Ho Peiyan, Cheong Rachel Chin Yee, Ong Siew Pei, Fusek Carol, Wee Shiou Liang, Yap Philip Lin Kiat
Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
Geriatric Education and Research Institute, Singapore, Singapore.
Dement Geriatr Cogn Dis Extra. 2021 Feb 2;11(1):1-9. doi: 10.1159/000513069. eCollection 2021 Jan-Apr.
Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient.
To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents' well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016).
Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents' well-being and staff attrition were measured before and after PCC implementation.
There were statistically significant improvements in resident well-being (Δ = 0.44, = 0.029), Positive Engagement Potential (Δ = 0.17, = 0.002), and Occupational Diversity (Δ = 0.12, = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC.
Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.
新加坡的传统养老院采用机构化和医疗化的护理模式，侧重于安全和风险管理。因此，对维护居民尊严和自主权的关注较少，这损害了护理质量和居民的福祉。如今，以人为主的护理（PCC）已成为维持护理接受者福祉和人格的高质量护理的代名词。
用逻辑模型描述一家养老院——顶点和谐小屋（AHL）所采用的PCC模式，并通过比较PCC实施前（2015年）和实施后（2016年）来评估对居民福祉、护理质量和员工流失率的影响。
使用痴呆症护理图谱对AHL一家拥有30张床位的痴呆症患者辅助生活设施中的男性居民进行评估。在PCC实施前后测量居民的福祉和员工流失率。
2016年，居民福祉（Δ = 0.44，P = 0.029）、积极参与潜力（Δ = 0.17，P = 0.002）和职业多样性（Δ = 0.12，P = 0.014）有统计学上的显著改善。居民的退缩和被动参与以及护理减分因素均显著减少。PCC实施后员工流失率也降低了55%。
PCC实施后，结果表明护理质量更高、居民福祉增强且员工留存率更高。AHL的PCC模式可为其他渴望提高护理质量的养老院提供路线图，并影响政策制定者和立法者的长期护理标准及法规。
