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丹麦临时24小时住宿收治患者的跨部门查房:案例研究

Intersectoral Ward Rounds on Patients Admitted to Temporary Twenty-Four-Hour Accommodations in Denmark: Case Study.

作者信息

Grew Julie, Thomsen Maj, Schiøtz Michaela Louise

机构信息

Center for Clinical Research and Prevention, DK.

North Zealand Hospital, DK.

出版信息

Int J Integr Care. 2022 Feb 11;22(1):12. doi: 10.5334/ijic.5688. eCollection 2022 Jan-Mar.

Abstract

INTRODUCTION

Temporary twenty-four-hour accommodations (TTAs) are municipal beds for elderly patients discharged from the hospital with acute treatment, care and/or rehabilitation needs that cannot be met in their own homes. TTAs are staffed by nurses and nursing assistants who are not authorized to prescribe or modify medications. At North Zealand Hospital one third of the many readmissions from a TTA within eight days after discharge have been assessed as preventable.

DESCRIPTION

A hospital-based team rounded on 268 patients at TTAs from May 2017 to October 2019 to promote integrated care. This study aimed to assess the efficacy of the rounding by auditing patient cases. A physician, a nurse, and a pharmacist from the hospital; a general practitioner; and one or two TTA nurses audited 17 cases.

DISCUSSION

Obtaining access to all electronic patient records and reconstructing information shared across sectors were not feasible in all cases.

CONCLUSION

An overview of the course of treatment was provided in most casesThe patient's health was enhanced in most cases and to a considerable or determining degree in half of casesMedication was optimized in most casesThe succeeding course of treatment was enhanced in more than half of the casesReadmission was prevented in some cases.

摘要

引言

临时24小时住宿设施(TTA)是为从医院出院的老年患者提供的市政床位,这些患者有急性治疗、护理和/或康复需求,但在自己家中无法得到满足。TTA配备有护士和护理助理,他们无权开处方或更改药物。在西兰德医院,许多从TTA出院后八天内再次入院的患者中,有三分之一被评估为可预防的。

描述

2017年5月至2019年10月,一个医院团队对TTA的268名患者进行了查房,以促进综合护理。本研究旨在通过审核患者病例来评估查房的效果。医院的一名医生、一名护士和一名药剂师;一名全科医生;以及一两名TTA护士审核了17个病例。

讨论

在所有情况下都无法获取所有电子患者记录并重建跨部门共享的信息。

结论

大多数情况下提供了治疗过程概述。大多数情况下患者健康得到改善,半数情况下有显著或决定性改善。大多数情况下药物得到优化。半数以上情况下后续治疗过程得到改善。在某些情况下预防了再次入院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bf/8833261/c9311c7a8bf0/ijic-22-1-5688-g1.jpg

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