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朝向发展一个国家病人转送文件在住家和急性照护之间-一个初步研究。

Towards the development of a national patient transfer document between residential and acute care-A pilot study.

机构信息

Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland.

St. Patrick's Hospital, Waterford, Ireland.

出版信息

Int J Older People Nurs. 2021 Jul;16(4):e12374. doi: 10.1111/opn.12374. Epub 2021 Mar 24.

Abstract

BACKGROUND

A lack of standardisation of documentation accompanying older people when transferring from residential to acute care is common and this may result in gaps in information and in care for older people. In Ireland, this lack of standardisation prompted the development of an evidence based national transfer document.

OBJECTIVES

To pilot a new national transfer document for use when transferring older people from residential to acute care and obtain the perceptions of its use from staff in residential and acute care settings.

METHODS

This was a pre- and post-study design using purposive sampling following the STROBE guidelines. The pilot was conducted in 26 sites providing residential care and three university hospitals providing acute care. Pre-pilot questionnaires focused on current documentation and were distributed to staff in residential care (n = 875). A pilot of the new paper-based transfer document was then conducted over three months and post-pilot questionnaires distributed to staff from both residential and acute care settings (n = 1085). The findings of the pilot study were discussed with multidisciplinary expert advisory and stakeholder groups who recommended some revisions. This consensus informed the development of the final design of the new revised transfer document.

RESULTS

Pre-pilot: 23% response rate; 83% (n = 168) participants agreed/strongly agreed that existing documentation was straightforward to complete but could be more person-centred. Post-pilot: 11% response rate; 75% (n = 93) of participants agreed/strongly agreed that the new transfer document promoted person-centred care but recommended revisions to the new document regarding layout and time to complete.

CONCLUSIONS

This study highlighted some of the challenges of providing safe, effective and relevant transfer information that is feasible and usable in everyday practice.

IMPLICATIONS FOR PRACTICE

Standardisation and being person-centred are important determining factors in the provision of relevant up to date information on the resident being transferred.

摘要

背景

老年人从养老院转移到急性护理机构时,伴随他们的文件通常缺乏标准化,这可能导致信息和护理方面的差距。在爱尔兰,这种缺乏标准化的情况促使开发了一种基于证据的国家转移文件。

目的

试用一种新的国家转移文件,用于将老年人从养老院转移到急性护理机构,并从养老院和急性护理机构的工作人员那里获得对该文件使用的看法。

方法

这是一项采用 STROBE 指南的前瞻性和回顾性研究设计。该试点在提供养老院护理的 26 个地点和提供急性护理的三所大学医院进行。预试点问卷主要关注当前的文件记录,并分发给养老院的工作人员(n=875)。然后,对新的纸质转移文件进行了为期三个月的试点,并向养老院和急性护理机构的工作人员分发了试点后问卷(n=1085)。试点研究的结果与多学科专家咨询和利益相关者小组进行了讨论,他们提出了一些修订建议。这些共识为新修订的转移文件的最终设计提供了依据。

结果

预试点:23%的回应率;83%(n=168)的参与者同意/强烈同意现有的文件记录填写简单,但可以更加以患者为中心。后试点:11%的回应率;75%(n=93)的参与者同意/强烈同意新的转移文件促进了以患者为中心的护理,但建议对新文件的布局和完成时间进行修订。

结论

这项研究强调了在日常实践中提供安全、有效和相关的转移信息所面临的一些挑战,这些信息具有可行性和实用性。

实践意义

标准化和以患者为中心是提供有关转移患者的相关、最新信息的重要决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd1/8365739/aa185b569a5e/OPN-16-e12374-g002.jpg

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