Faculty of Health Sciences, Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
J Clin Nurs. 2022 Sep;31(17-18):2495-2506. doi: 10.1111/jocn.16062. Epub 2021 Sep 27.
To explore and describe the work performed by the nurses providing hospital-at-home care to children and their families from the perspectives of hospital nurses and physicians.
To reduce capacity pressure on hospitals, various ambulatory services combining hospital and home treatment have emerged. Studies have shown that children and their families are satisfied with hospital-at-home when the parents experienced the professionals possessed the necessary competences. Knowledge is limited about nurses and physicians' perspectives on the work performed and competence needed when children receive hospital treatment in the family's home.
A qualitative descriptive design with semi-structured interviews was used. Sixteen nurses and physicians from two hospitals in Norway working in hospital-at-home for children were recruited to interview. Data were analysed using systematic text condensation. In preparing the manuscript, we applied the COREQ guidelines. The theory on 'expert nursing' supported the discussion of results.
We identified three categories through analysis; building a trustful relationship with the family and the sick child; performing essential skills in paediatric nursing care in hospital-at-home; and nurses serving as the 'hub' between the different parties.
The results demonstrate the complexity of the work performed by hospital nurses when children received hospital-at-home. Building a trustful relationship and alliance with the child and the family formed the cornerstone of accomplishing good and safe paediatric care. The nurses became a coordinating and collaborating 'hub' for actors involved, taking care of patient safety on a daily basis.
The way the nurses approached the children and their families, was the core element of the paediatric nursing expertise and important for the service quality and patient safety. The importance of building a trustful relationship needs to be more acknowledged, and the services would benefit to organise this through continuity of care.
从医院护士和医生的角度探讨和描述为在家中接受医院治疗的儿童及其家庭提供服务的护士的工作。
为了减轻医院的容量压力，出现了各种结合医院和家庭治疗的门诊服务。研究表明，当父母体验到专业人员具备必要的能力时，儿童及其家庭对在家中接受医院治疗的服务感到满意。关于护士和医生对儿童在家中接受医院治疗时所进行的工作和所需能力的看法，相关知识有限。
采用半结构式访谈的定性描述设计。从挪威的两家医院招募了 16 名从事儿童家庭医院治疗的护士和医生进行访谈。使用系统文本浓缩法分析数据。在准备手稿时，我们应用了 COREQ 指南。“专家护理”理论支持了结果的讨论。
通过分析，我们确定了三个类别；与家庭和患病儿童建立信任关系；在家中进行儿科护理的基本技能；护士充当不同各方之间的“枢纽”。
研究结果表明，当儿童接受家庭医院治疗时，医院护士的工作非常复杂。与儿童及其家庭建立信任关系和联盟是提供良好和安全儿科护理的基石。护士成为涉及的各方之间的协调和合作“枢纽”，每天负责患者的安全。
护士与儿童及其家庭的相处方式是儿科护理专业知识的核心要素，对服务质量和患者安全至关重要。建立信任关系的重要性需要得到更多的认可，而服务可以通过连续护理来组织这一点。
