对澳大利亚老年护理机构中医疗保健和生活方式决策的组织政策的审查。

An examination of organisational policies for healthcare and lifestyle decision-making among Australian aged care providers.

作者信息

Sinclair Craig, Field Sue, Blake Meredith, Radoslovich Helen

机构信息

Rural Clinical School of Western Australia (Albany), University of Western Australia (Albany Centre), Albany, Western Australia, Australia.

University of Western Australia, Perth, Western Australia, Australia.

出版信息

Australas J Ageing. 2019 Sep;38 Suppl 2:90-97. doi: 10.1111/ajag.12610.

DOI:10.1111/ajag.12610

PMID:31496062

Abstract

OBJECTIVE

Examine policies of aged care organisations relating to healthcare and lifestyle decision-making.

METHODS

Seven aged care organisations submitted policy documents. Policies were analysed using the Australian Law Reform Commission (ALRC) "Decision-Making Principles" as a framework. Senior staff (N = 9) with policy development roles participated in follow-up interviews.

RESULTS

The structure and content of policy documents varied significantly between organisations. Most acknowledged the need to support the rights of care recipients in decision-making; however, the nature of this support was often unclear. Interview themes included factors relating to "organisational contexts" "policy development and implementation" and "ethical challenges." An overarching theme among high-performing organisations was "proactive response aimed at pre-empting decision-making dilemmas". We provide recommendations for policy development, including a self-assessment audit tool.

CONCLUSION

Aged care provider organisations may need to review policies in the areas of healthcare and lifestyle decision-making to meet current best practice principles.

摘要

目的

研究老年护理机构在医疗保健和生活方式决策方面的政策。

方法

七家老年护理机构提交了政策文件。以澳大利亚法律改革委员会（ALRC）的“决策原则”为框架对政策进行分析。担任政策制定工作的高级工作人员（N = 9）参与了后续访谈。

结果

各机构政策文件的结构和内容差异显著。大多数机构承认有必要在决策中支持护理接受者的权利；然而，这种支持的性质往往不明确。访谈主题包括与“组织背景”“政策制定与实施”以及“伦理挑战”相关的因素。高效能机构的一个总体主题是“旨在预防决策困境的积极应对”。我们为政策制定提供了建议，包括一个自我评估审计工具。