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[德国老年跨部门护理中过渡护理模式组件的使用——一项调查结果]

[Use of components of the transitional care model in geriatric cross-sectoral care in Germany-Results of a survey].

作者信息

Morkisch Nadine, Upegui-Arango Luz Dary, van den Heuvel Dirk

机构信息

Bundesverband Geriatrie e. V., Reinickendorfer Str. 61, 13347, Berlin, Deutschland.

出版信息

Z Gerontol Geriatr. 2021 Feb;54(1):40-46. doi: 10.1007/s00391-020-01804-4. Epub 2020 Nov 2.

DOI:10.1007/s00391-020-01804-4
PMID:33140132
Abstract

BACKGROUND

The inclusion of transitional care professionals to improve the sectoral interface management is politically supported. The nine components of the transitional care model (TCM) originating from the USA, are used in a randomized controlled trial within the TIGER project, which is funded by the Federal Joint Committee of Germany. Geriatric patients are accompanied prior to discharge from hospital and up to 12 months after discharge in the home environment.

OBJECTIVE

Within the framework of the TIGER project a nationwide survey was carried out on the use of the TCM components in the accompanied transition from hospital to home in the field of geriatrics.

MATERIAL AND METHODS

A data collection was set up to establish contact with people from the immediate and care policy environment of geriatrics. In a 2-stage process, the first question was whether a geriatric project was known that focuses on the transition from hospital to home in geriatric patients. After confirmation, a questionnaire could be filled out online or by post.

RESULTS

A total of 31 different projects out of 39 answered questionnaires were identified. Principally, all TCM components were used in the projects. The TCM component 9 that describes the coordination of support and aids, was mentioned most often (n = 30). The TCM components 6 (improvement in self-management) and 8 (promoting continuity) were used in only 19 projects.

CONCLUSION

Management of the transsectoral transition is a current topic in the field of geriatrics in Germany. The TCM components that have proved to be important in reducing hospital readmission rates have predominantly been used in the projects.

摘要

背景

引入过渡护理专业人员以改善部门间接口管理得到了政治支持。源自美国的过渡护理模式(TCM)的九个组成部分,被用于由德国联邦联合委员会资助的TIGER项目中的一项随机对照试验。老年患者在出院前及出院后长达12个月的居家环境中都得到陪伴。

目的

在TIGER项目框架内,针对老年医学领域从医院到家庭的陪伴式过渡中TCM组成部分的使用情况开展了一项全国性调查。

材料与方法

建立了一个数据收集系统,以便与老年医学直接相关人员及护理政策环境中的人员取得联系。在一个两阶段过程中,第一个问题是是否知晓有一个专注于老年患者从医院到家庭过渡的老年医学项目。确认后,可以在线或通过邮寄方式填写问卷。

结果

在39份回复问卷中,共识别出31个不同项目。原则上,所有TCM组成部分都在这些项目中被使用。描述支持与援助协调的TCM组成部分9被提及的次数最多(n = 30)。TCM组成部分6(自我管理改善)和8(促进连续性)仅在19个项目中被使用。

结论

跨部门过渡管理是德国老年医学领域当前的一个话题。已证明在降低医院再入院率方面很重要的TCM组成部分在这些项目中得到了主要应用。

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Transitional care interventions and hospital readmissions in surgical populations: a systematic review.外科人群中的过渡性护理干预与医院再入院:一项系统综述
Am J Surg. 2016 Aug;212(2):327-35. doi: 10.1016/j.amjsurg.2016.04.004. Epub 2016 Jun 1.
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Continuity of Care: The Transitional Care Model.连续性护理:过渡性护理模式。
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