Collier Aileen, De Bellis Anita, Hosie Annmarie, Dadich Ann, Symonds Tamsin, Prendergast Justin, Rodrigues Jade, Bevan Alan
University of Auckland, Auckland, New Zealand.
Flinders University, Adelaide, SA, Australia.
J Clin Nurs. 2020 Jun;29(11-12):1957-1967. doi: 10.1111/jocn.15056. Epub 2019 Oct 7.
To clarify how high-quality fundamentals of care for people with dementia and/or delirium were practised in a specialist geriatric evaluation and management unit.
Older people with cognitive impairment represent a significant number of people who are admitted to hospital. They are at increased risk of dying, readmission and long hospital stays, relative to those without cognitive impairment. There is an urgent need to elucidate the conditions that underpin safe and high-quality fundamental care for these patients and their families.
Using the innovative methodologies of positive organisational scholarship in healthcare and video-reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people with dementia and/or delirium in South Australia. Patients, family members and staff members (managerial, clinical and nonclinical) participated by allowing researchers to document ethnographic fieldwork notes and film their practices and/or accounts thereof; and/or interpreting digital recordings with researchers in order to make sense of data in a process of co-analysis. This study is reported using Standards for Reporting Qualitative Research reporting guidelines.
High-quality fundamental care for people with dementia and/or delirium in hospital and their families was associated with the special space of the hospital unit; an aptitude for people with dementia; a capacity to translate person-centred fundamentals of care from rhetoric to reality; and an appreciation for teamwork.
This study clarified how teams working in hospital can practise high-quality fundamentals of care for older people with dementia and/or delirium. Delivery of high-quality fundamental care in this setting was dependent, not only on nurses, but the entire ward team working cohesively in a "weave of commitment."
Efforts to improve fundamental care for people with cognitive impairment need to encompass values and philosophy of person-centred care, including the contributions by all staff to care delivery.
阐明在一个专科老年评估与管理单元中，如何为患有痴呆症和/或谵妄的患者提供高质量的基本护理。
认知障碍的老年人占住院患者的很大比例。相对于没有认知障碍的患者，他们死亡、再次入院和住院时间延长的风险更高。迫切需要阐明为这些患者及其家人提供安全和高质量基本护理的条件。
本研究采用医疗保健领域积极组织学术研究的创新方法以及视频反思民族志，在南澳大利亚的一个针对患有痴呆症和/或谵妄患者的住院老年评估与管理单元中进行，为期18个月。患者、家庭成员和工作人员（管理人员、临床人员和非临床人员）参与其中，允许研究人员记录民族志田野笔记并拍摄他们的做法和/或相关描述；和/或与研究人员一起解读数字记录，以便在共同分析过程中理解数据。本研究按照定性研究报告标准进行报告。
在医院为患有痴呆症和/或谵妄的患者及其家人提供高质量基本护理与医院单元的特殊空间、对痴呆症患者的能力倾向、将以患者为中心的基本护理从言辞转化为现实的能力以及对团队合作的重视有关。
本研究阐明了医院团队如何为患有痴呆症和/或谵妄的老年人提供高质量的基本护理。在这种情况下提供高质量的基本护理不仅取决于护士，还取决于整个病房团队以“奉献之网”的方式紧密合作。
改善对认知障碍患者基本护理的努力需要涵盖以患者为中心的护理的价值观和理念，包括所有工作人员对护理提供的贡献。
