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提高有复杂医疗需求的儿童的护理水平:爱尔兰社区卫生组织的一个改进项目。

Enhancing care of children with complex healthcare needs: an improvement project in a community health organisation in Ireland.

机构信息

School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Ireland

Primary Care General Manager, Health Service Executive, Ballyshannon, Ireland.

出版信息

BMJ Open Qual. 2021 Feb;10(1). doi: 10.1136/bmjoq-2020-001025.

Abstract

BACKGROUND

Integration of care for children with complex care needs is developing slowly internationally. There remains wide variation in the governance of, and access to, care for these children and their families.

LOCAL PROBLEM

There was a need to develop a service that would have a specific remit for organising the overall management and governance of the care of these children in the community.

METHOD

A bespoke model was established specifically to support the needs of children with complex healthcare needs (CHNs). The sole focus of the team is to provide the highest standard of care to these children and their families, and to enable families to remain central to decision-making.

INTERVENTION

The service for children with CHNs was established in August 2017 with the appointment of a service manager and case managers. A comprehensive training and education programme was put in place to support care to the children and their families.

RESULTS

The service is viewed as delivering high-quality care. Parents and stakeholders highlighted the value placed within the service on individualised care, specialist knowledge and the importance of advocacy.

CONCLUSIONS

The model recognises the exceptional lives these children and families live, given the complexities and challenges they have to overcome on a daily basis. The team have built a specialist knowledge and skill set in supporting families and others involved in the care of the child, as they are solely employed and dedicated to the provision of care to children with CHNs. The corporate governance structures seem strong and stand up to scrutiny very well in terms of parents' and stakeholders' perspectives and in the context of published international best practice.

摘要

背景

国际上,对有复杂护理需求的儿童进行综合护理的工作进展缓慢。这些儿童及其家庭的护理管理和可及性仍存在广泛差异。

本地问题

需要开发一种服务,专门负责组织社区中这些儿童的整体管理和护理。

方法

专门建立了一个定制模型,以满足有复杂医疗保健需求(CHN)的儿童的需求。该团队的唯一重点是为这些儿童及其家庭提供最高标准的护理,并使家庭能够继续成为决策的核心。

干预措施

2017 年 8 月设立了儿童 CHN 服务,任命了服务经理和个案经理。还制定了全面的培训和教育计划,以支持儿童及其家庭的护理。

结果

该服务被认为提供了高质量的护理。家长和利益相关者强调了服务在个性化护理、专业知识和倡导方面的价值。

结论

该模型认识到这些儿童及其家庭所面临的特殊生活,考虑到他们每天必须克服的复杂性和挑战。团队在支持家庭和其他参与儿童护理的人员方面积累了专业知识和技能,因为他们是专门受雇并致力于为有 CHN 的儿童提供护理。从家长和利益相关者的角度来看,以及从发表的国际最佳实践来看,公司治理结构似乎很强,经得起审查。

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