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评估以痴呆症患者为中心的康复住院护理模式的实施和效果:项目方案。

Evaluating Implementation and Outcomes of a Person-Centered Care Model for People with Dementia in the Rehabilitation In-Patient Setting: Project Protocol.

机构信息

Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, NSW, Australia.

School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, Penrith, NSW, Australia.

出版信息

J Alzheimers Dis. 2023;91(4):1409-1421. doi: 10.3233/JAD-220882.

Abstract

BACKGROUND

While Australian guidelines promote person-centered healthcare (PCC) for persons with dementia, healthcare systems, routines, rules, and workplace cultures can pose challenges in the provision of PCC.

OBJECTIVE

To present a knowledge translation protocol of the PCC model in a sub-acute rehabilitation hospital.

METHODS

The two-year pre/post/follow-up translation project will include (n = 80) persons with dementia, (n = 80) adult family/carers of patient participants, (n = 60) healthcare staff (medical, nursing, allied health), and (n = 8) PCC staff champions. Champions will complete six half-days' training in PCC. Medical, nursing, and allied health staff will be provided with PCC learning manuals, complete six hours of online PCC education and attend six face-to-face PCC education sessions. Champions will provide ongoing support to staff in PCC practice. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework will be used to evaluate: i) outcomes for prospective patients provided with PCC, compared with a matched sample of retrospective patients (primary outcomes agitation incidence and severity); 2) champion and staff PCC knowledge, confidence, engagement, and practice quality; 3) person, family/carer, champion, and staff satisfaction with PCC; 4) PCC costs and benefits; and 5) organizational structures, systems and policies required to implement and maintain PCC in sub-acute healthcare.

RESULTS

We will identify if PCC benefits persons with dementia, staff, and healthcare services, and we will generate evidence on the educational and organizational resources required to embed PCC in practice.

CONCLUSION

Project findings will inform tailored PCC education applications for dissemination in healthcare and produce evidence-based PCC practice guidelines to improve healthcare for persons with dementia.

摘要

背景

尽管澳大利亚的指南提倡以患者为中心的医疗保健(PCC),但医疗保健系统、常规、规则和工作场所文化可能会对提供 PCC 造成挑战。

目的

介绍亚急性康复医院中 PCC 模型的知识转化方案。

方法

为期两年的预/后/随访转化项目将包括(n=80)名痴呆症患者、(n=80)名成年患者家属/照护者、(n=60)名医护人员(医疗、护理、联合健康)和(n=8)名 PCC 工作人员拥护者。拥护者将完成六天半的 PCC 培训。医护人员将获得 PCC 学习手册,完成六小时的在线 PCC 教育,并参加六次面对面的 PCC 教育课程。拥护者将为员工提供 PCC 实践的持续支持。将使用“范围、有效性、采用、实施和维持(RE-AIM)”框架来评估:i)与回顾性患者样本相比,接受 PCC 治疗的预期患者的结果(主要结果为激越发生率和严重程度);2)拥护者和员工的 PCC 知识、信心、参与度和实践质量;3)患者、家属/照护者、拥护者和员工对 PCC 的满意度;4)PCC 的成本和效益;5)实施和维持亚急性医疗保健中 PCC 所需的组织结构、系统和政策。

结果

我们将确定 PCC 是否有益于痴呆症患者、员工和医疗保健服务,并将生成有关将 PCC 嵌入实践所需的教育和组织资源的证据。

结论

项目研究结果将为在医疗保健中传播定制的 PCC 教育应用提供信息,并产生循证 PCC 实践指南,以改善痴呆症患者的医疗保健。

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