探索荷兰地区护理中护士敏感的患者结局：一项调查研究。
Exploring nurse-sensitive patient outcomes in Dutch district nursing care: A survey study.
机构信息
Research Centre for Healthy and Sustainable Living, Faculty of Health Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands.
Department of General Practice, Division Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Health Soc Care Community. 2022 Nov;30(6):e5624-e5636. doi: 10.1111/hsc.13988. Epub 2022 Sep 11.
There is a lack of evidence to guide district nurses in using nurse-sensitive patient outcomes as it is unclear how these outcomes are currently used in daily district nursing practice. Therefore, we aimed to explore (1) which nurse-sensitive patient outcomes are measured and how these outcomes are measured, (2) how district nurses use the outcomes to learn from and improve current practice and (3) the barriers and facilitators to using outcomes in current district nursing practice. An exploratory cross-sectional survey study was conducted. The survey was distributed online among nurses working for various district nursing care organisations across the Netherlands. The responses from 132 nurses were analysed, demonstrating that different instruments or questionnaires are available and used in district nursing care as outcome measures. The nurse-sensitive patient outcomes most often measured with validated instruments are pain using the Numeric Rating Scale or Visual Analogue Scale, delirium using the Delirium Observation Scale, weight loss using the Short Nutritional Assessment Questionnaire and caregiver burden using the Caregiver Strain Index or a Dutch equivalent. Falls and client satisfaction with delivered care are most often measured using unvalidated outcome measures. The other nurse-sensitive outcomes are measured in different ways. Outcomes are measured, reported and fed back to the nursing team multiple times and in various ways to learn from and improve current practice. In general, nurses have a positive attitude towards using nurse-sensitive outcomes in practice, but there is a lack of facilitation to support them. Because insight into how nurses can and should be supported is still lacking, exploring their needs in further research is desirable. Additionally, due to the high variation in the utilisation of outcomes in current practice, it is recommended to create more uniformity by developing (inter)national guidelines on using nurse-sensitive patient outcomes in district nursing care.
目前缺乏指导地区护士使用护士敏感的患者结局指标的证据，因为目前尚不清楚这些结局指标在日常地区护理实践中是如何使用的。因此，我们旨在探讨：（1）哪些护士敏感的患者结局指标被测量，以及这些结局指标是如何被测量的；（2）地区护士如何利用这些结果来从当前实践中学习并加以改进；（3）在当前地区护理实践中使用结果的障碍和促进因素。进行了一项探索性的横断面调查研究。该调查在线分发给荷兰各地各种地区护理护理组织的护士。对 132 名护士的回复进行了分析，结果表明，不同的工具或问卷可作为地区护理护理中的结果测量指标使用。最常使用经过验证的工具来测量的护士敏感的患者结局指标是使用数字评分量表或视觉模拟量表来测量疼痛、使用 Delirium Observation Scale 来测量谵妄、使用 Short Nutritional Assessment Questionnaire 来测量体重减轻以及使用 Caregiver Strain Index 或等效的荷兰语量表来测量照顾者负担。使用未经验证的结果测量指标最常测量跌倒和客户对所提供护理的满意度。其他护士敏感的结局指标以不同的方式进行测量。结果被多次、以多种方式进行测量、报告和反馈给护理团队，以从当前实践中学习并加以改进。总的来说，护士对在实践中使用护士敏感的结果指标持积极态度，但缺乏支持他们的手段。由于对如何支持护士的认识仍然不足，因此在进一步的研究中探索他们的需求是可取的。此外，由于当前实践中对结果的利用存在很大的差异，因此建议通过制定（国际）关于在地区护理中使用护士敏感的患者结局指标的指南，来创造更多的统一性。
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