School of Nursing, Midwifery and Social Science, Central Queensland University, Townsville campus, Townsville, Queensland, Australia.
Research Division, Central Queensland University, Brisbane campus, Brisbane, Queensland, Australia.
PLoS One. 2020 Aug 24;15(8):e0237306. doi: 10.1371/journal.pone.0237306. eCollection 2020.
The management of patients who need chronic and complex care is a focus of attention internationally, brought about by an increase in chronic conditions, requiring significantly more care over longer periods of time. The increase in chronic conditions has placed pressure on health services, financially and physically, bringing about changes in the way care is delivered, with hospital avoidance and home-based care encouraged. In this environment, nurses play an important role in co-ordinating care across services. This review formed one part of a funded project that explored the nurse navigator role within a proposed 24-hour telephone-call service in one regional area that has a diverse population in terms of cultural identity and geographical location in relation to service access.
The review reports on the extant literature on the nurse's role in the provision of afterhours telephone services for patients with chronic and complex conditions. The specific aim was to explore the effectiveness of services for patients in geographically isolated locations.
The methodological approach to the review followed the Preferred Reporting System for Meta-Analyses (PRISMA) guidelines. A thematic analysis was used to identify themes with chronic care models underpinning analysis.
Three themes were identified; nurse-led decision making; consumer profile; and program outcomes. Each theme was divided into two sub-themes. The two sub-themes for decision making were: the experience of the staff who provided the service and the tool or protocol used. The two sub-themes for consumers profile were; the geographic/demographic identity of the consumers, and consumer satisfaction. The final theme of outcomes describes how the effectiveness of the service is measured, broken into two sub-themes: the economic/workforce outcomes and the consumer outcomes.
The provision of an after-hours telephone service, in whatever model used should align with a Chronic Care Model. In this way, after-hours telephone services provided by experienced nurses, supported by ongoing professional development and relevant protocols, form part of the ongoing improvement for chronic and complex care management as a health priority.
对需要长期、复杂护理的患者的管理是国际关注的焦点，这是由慢性病的增加引起的，这些疾病需要更长时间的大量护理。慢性病的增加给卫生服务带来了经济和身体上的压力，导致护理方式发生了变化，鼓励避免住院和家庭护理。在这种环境下，护士在协调跨服务的护理方面发挥着重要作用。本次审查是一个资助项目的一部分，该项目探讨了在一个区域内提出的 24 小时电话服务中护士导航员的角色，该区域在文化认同和地理位置与服务可及性方面具有多样化的人口。
该审查报告了关于护士在为患有慢性和复杂疾病的患者提供下班后电话服务方面的现有文献。具体目的是探讨为地理位置偏远的患者提供服务的有效性。
审查采用的方法遵循系统评价报告的首选报告系统（PRISMA）指南。使用主题分析来确定以慢性病护理模型为基础的分析主题。
确定了三个主题；护士主导的决策；消费者概况；和计划结果。每个主题分为两个子主题。决策的两个子主题是：提供服务的工作人员的经验以及使用的工具或协议。消费者概况的两个子主题是：消费者的地理/人口特征和消费者满意度。最后一个主题描述了如何衡量服务的效果，分为两个子主题：经济/劳动力结果和消费者结果。
无论使用何种模式，下班后电话服务的提供都应与慢性病护理模型保持一致。通过这种方式，由经验丰富的护士提供的下班后电话服务，通过持续的专业发展和相关协议提供支持，成为慢性病和复杂护理管理作为健康优先事项的持续改进的一部分。
