Geisinger Home Infusion Services, Danville, Pennyslvania, USA.
Boston Children's Hospital Boston, Boston, Massachusetts, USA.
Nutr Clin Pract. 2022 Jun;37(3):493-508. doi: 10.1002/ncp.10861. Epub 2022 May 19.
Transitions of care require coordination between inpatient healthcare providers, care managers, outpatient/ambulatory providers, and the patient/caregiver and family members. Poor communication during transitions of care can affect health outcomes and economic costs for patients/caregivers, healthcare providers, and healthcare systems. The goal of this paper is to identify risk-prone processes in the transition of care for patients requiring parenteral nutrition (PN) between healthcare environments, including the hospital, home, skilled nursing facility, and long-term acute care hospital settings. To facilitate the evaluation of the transition, a sequential series of steps in the transition process were identified: initial notification, assessment in preparation for transfer, identifying the receiving organization, identifying accountable providers at each sending/receiving organization, communicating the nutrition care plan, implementing the plan and additional considerations regarding PN preparation and readmissions. Safety concerns with risk-prone processes are identified and recommended best practices are proposed for improving processes at each step of the transition. Pediatric considerations are included in the evaluation of the various steps in the transition of care. This paper was approved by the American Society for Parenteral and Enteral Nutrition (ASPEN) Board of Directors.
在患者从一个医疗环境（如医院、家庭、养老院和长期急性护理医院）过渡到另一个医疗环境的过程中，需要住院医疗服务提供者、护理管理人员、门诊/流动医疗服务提供者以及患者/照护者和家庭成员之间的协调。在医疗服务过渡过程中沟通不畅可能会影响患者/照护者、医疗服务提供者和医疗保健系统的健康结果和经济成本。本文的目的是确定需要肠外营养（PN）的患者在医疗环境之间过渡时存在风险的过程，包括医院、家庭、熟练护理设施和长期急性护理医院环境。为了便于评估过渡，确定了过渡过程中的一系列步骤：初始通知、准备转移的评估、确定接收组织、确定每个发送/接收组织的责任提供者、沟通营养护理计划、实施计划以及关于 PN 准备和再入院的其他注意事项。确定了存在风险的过程中的安全问题，并提出了改进过渡各个步骤的最佳实践建议。在评估过渡护理的各个步骤时，纳入了儿科注意事项。本文已获得美国肠外和肠内营养学会（ASPEN）理事会的批准。
