Carpenter Joan, Miller Susan C, Kolanowski Ann M, Karel Michele J, Periyakoil Vyjeyanthi S, Lowery Jill, Levy Cari, Sales Anne E, Ersek Mary
J Gerontol Nurs. 2019 Mar 1;45(3):21-30. doi: 10.3928/00989134-20190211-03.
The goal of this quality improvement project is to improve care planning around preferences for life-sustaining treatments (LST) and daily care to promote quality of life, autonomy, and safety for U.S. Department of Veterans Affairs (VA) Community Living Center (CLC) (i.e., nursing home) residents with dementia. The care planning process occurs through partnerships between staff and family surrogate decision makers. This process is separate from but supports implementation of the LST Decision Initiative-developed by the VA National Center for Ethics in Health Care-which seeks to increase the number, quality, and documentation of goals of care conversations (GOCC) with Veterans who have life-limiting illnesses. The current authors will engage four to six VA CLCs in the Mid-Atlantic states, provide teams with audit and feedback reports, and establish learning collaboratives to address implementation concerns and support action planning. The expected outcomes are an increase in CLC residents with dementia who have documented GOCC and LST plans. [Journal of Gerontological Nursing, 45(3), 21-30.].
这个质量改进项目的目标是改善围绕维持生命治疗（LST）偏好和日常护理的护理计划，以提高美国退伍军人事务部（VA）社区生活中心（CLC，即疗养院）痴呆症患者的生活质量、自主性和安全性。护理计划过程通过工作人员与家庭替代决策者之间的合作来进行。这个过程与VA国家医疗保健伦理中心制定的LST决策倡议的实施是分开的，但为其提供支持，该倡议旨在增加与患有危及生命疾病的退伍军人进行的护理目标对话（GOCC）的数量、质量和记录。本文作者将在大西洋中部各州的四到六个VA CLC开展工作，为团队提供审计和反馈报告，并建立学习协作组以解决实施问题并支持行动计划。预期结果是记录有GOCC和LST计划的CLC痴呆症患者数量增加。[《老年护理杂志》，45(3)，21 - 30。]
