Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA. 95616.
College of Nursing, Penn State, University Park, Pa.16802.
Nurs Outlook. 2021 Sep-Oct;69(5):735-743. doi: 10.1016/j.outlook.2021.03.017. Epub 2021 Apr 5.
COVID-19 has exposed the longstanding internal problems in nursing homes and the weak structures and policies that are meant to protect residents. The Centers for Medicare and Medicaid Services convened the Coronavirus Commission for Safety and Quality in NHs in April, 2020 to address this situation by recommending steps to improve infection prevention and control, safety procedures, and the quality of life of residents in nursing homes. The authors of this paper respond to the Final Report of the Commission and put forth additional recommendations to federal policymakers for meaningful nursing home reform: 1) ensuring 24/7 registered nurse (RN) coverage and adequate compensation to maintain total staffing levels that are based on residents' care needs; 2) ensuring RNs have geriatric nursing and leadership competencies; 3) increasing efforts to recruit and retain the NH workforce, particularly RNs; and 4) supporting care delivery models that strengthen the role of the RN for quality resident-centered care.
新冠疫情暴露了养老院长期存在的内部问题,以及旨在保护居民的脆弱结构和政策。2020 年 4 月,医疗保险和医疗补助服务中心召集了 NH 冠状病毒安全和质量委员会,通过建议采取措施改善感染预防和控制、安全程序以及养老院居民的生活质量来解决这一问题。本文作者对委员会的最终报告做出了回应,并向联邦政策制定者提出了养老院改革的其他建议:1)确保 24/7 注册护士(RN)覆盖和足够的补偿,以维持基于居民护理需求的总人员配置水平;2)确保 RN 具备老年护理和领导力能力;3)加大力度招聘和留住 NH 劳动力,特别是 RN;4)支持加强 RN 在以居民为中心的优质护理中作用的护理提供模式。