Gautun Heidi, Hartford Kvæl Linda Aimée, Bratt Christopher
Norwegian Social Research, NOVA, Oslo Metropolitan University, 0130 Oslo, Norway.
Department of Psychology, Inland Norway University of Applied Sciences, 2624 Lillehammer, Norway.
Healthcare (Basel). 2022 Mar 3;10(3):475. doi: 10.3390/healthcare10030475.
In most European countries, communities need to provide health and social care services to an increasing number of severely ill patients discharged from hospitals. We investigated whether nurses in hospitals and in the communities' health and social care services experienced that the administration in the municipalities allocated older patients the right type of services after hospital discharge.
We used data from Norway, with a qualitative pilot study and quantitative analysis (structural equation modeling) of surveys involving 2431 nurses on inpatient wards in acute hospitals and 4312 nurses working in nursing homes or home nursing.
Dissatisfaction was widespread with the use of patients' homes the first days after hospital discharge. Among nurses working in hospitals, 38% were commonly or very commonly disagreeing with the use of the patient's home after hospital discharge, 25% among home nurses, and 18% among nurses in nursing homes. Home nurses were more prone to oppose the use of patients' homes if they also experienced that their service had inadequate staffing or inadequate medical equipment.
This research indicates conflicting priorities between the bureaucracy and nurses involved in actual work with older patients. From the nurses' perspective, the municipalities' administration was offering too few older patients short-term-stay in an intermediate care institution as part of the clinical pathway from hospital to home. However, providing more recourses to home nursing would improve their ability to provide sufficient care to older patients discharged from hospital.
在大多数欧洲国家，社区需要为越来越多从医院出院的重症患者提供健康和社会护理服务。我们调查了医院护士以及社区健康和社会护理服务机构的护士是否认为市政当局在患者出院后为老年患者分配了合适类型的服务。
我们使用了来自挪威的数据，进行了一项定性试点研究以及对调查数据的定量分析（结构方程模型），涉及急性医院住院病房的2431名护士以及在养老院或家庭护理机构工作的4312名护士。
对出院后最初几天让患者回家的做法普遍存在不满。在医院工作的护士中，38%通常或非常不同意出院后让患者回家；家庭护理护士中这一比例为25%，养老院护士中为18%。如果家庭护理护士还觉得他们的服务人员配备不足或医疗设备不足，就更倾向于反对让患者回家。
这项研究表明，在负责老年患者实际工作的官僚机构和护士之间存在相互冲突的优先事项。从护士的角度来看，市政当局作为从医院到家庭的临床路径的一部分，为老年患者提供的短期入住中间护理机构的机会太少。然而，为家庭护理提供更多资源将提高他们为从医院出院的老年患者提供充分护理的能力。
