School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.
Department of Aged Care, St. George Hospital, Kogarah, New South Wales, Australia.
Australas J Ageing. 2023 Jun;42(2):374-381. doi: 10.1111/ajag.13139. Epub 2022 Nov 21.
The objective of the study was to evaluate the effect of two self-designed structured clinical tools on overall self-perceptions of confidence in the assessment, management and communication of acutely unwell residents in nursing and care staff of residential aged care facilities (RACFs).
Quasi-experimental pre-post design using surveys in 22 RACFs in Metropolitan Sydney, Australia. A convenience sample of 254 nursing and care staff were recruited. Two structured tools were developed to enhance confidence: (1) RACF Emergency Decision Index (REDI) and (2) Clinical Handover Assessment Tool (CHAT). The REDI is a clinical decision guide for treatment implementation and escalation, and the CHAT is a structured communication aid. Surveys were administered to participating nursing and care staff working within the RACFs prior to the implementation of the two structured tools (T0) and 6 months later (T1).
There was a significant increase in reported overall confidence in assessing and managing acutely unwell residents 6 months after the implementation of the REDI and CHAT (p = 0.003 and p = 0.006, respectively). Baseline Confidence in Assessment Scale and Confidence in Management Scale scores differed significantly 6 months following the implementation of the REDI and CHAT tools (p < 0.001). There was improvement across all surveyed communication domains.
Preliminary data suggested that the two structured tools are effective in increasing confidence in the assessment, management and communication of acutely unwell residents for nursing and care staff working in RACFs.
本研究旨在评估两种自行设计的结构化临床工具对护理人员和养老院居民的整体自我评估、管理和沟通急性不适居民的信心的影响。
在澳大利亚悉尼大都市区的 22 家养老院中进行了准实验前后设计的调查。招募了 254 名护理人员和护理人员作为便利样本。开发了两种增强信心的结构化工具：（1）养老院紧急决策指数（REDI）和（2）临床交接评估工具（CHAT）。REDI 是一种用于治疗实施和升级的临床决策指南，CHAT 是一种结构化的沟通辅助工具。在实施这两种结构化工具之前（T0）和 6 个月后（T1），对在养老院工作的参与护理人员和护理人员进行了调查。
在实施 REDI 和 CHAT 后 6 个月，报告的整体评估和管理急性不适居民的信心显著增加（p=0.003 和 p=0.006）。REDI 和 CHAT 工具实施后 6 个月，信心评估量表和信心管理量表的基线评分差异显著（p<0.001）。所有调查的沟通领域都有所改善。
初步数据表明，这两种结构化工具可有效提高护理人员和养老院居民对急性不适居民的评估、管理和沟通的信心。
