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从医院到家庭医疗保健转移时,过渡干预对确保患者安全和满意度的影响——系统评价。

The effect of transitions intervention to ensure patient safety and satisfaction when transferred from hospital to home health care-A systematic review.

机构信息

Faculty of Health Sciences, VID Specialized University, Bergen, Norway.

Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway.

出版信息

J Adv Nurs. 2023 Jun;79(6):2098-2118. doi: 10.1111/jan.15579. Epub 2023 Feb 10.

Abstract

AIM

The aim of this systematic review is to describe and evaluate the effectiveness of transition interventions to safeguard patient safety and satisfaction during patients' transition from hospital to home health care.

DESIGN

Systematic review.

DATA SOURCES

MEDLINE, Ovid Nursing Database, PsycINFO, EMBASE, CINAHL, Clinical Trials and SveMed+ was systematic searched in January 2019 and September 2020 to identify peer-reviewed papers. No language, geographical or publication date restrictions.

REVIEW METHODS

Cochrane Handbook for Systematic Reviews of Interventions was used. Data analysis focused on aggregated data and a descriptive synthesis. Risk of bias was rated using Cochrane risk-of-bias tool.

RESULTS

In total, 10,524 references were identified in the literature search, twenty-six articles were included. The interventions were divided into three main groups: (i). systematic patient education pre-discharge; (ii). establishment of contact with the local healthcare services pre-discharge and (iii). follow-up initiated by nurses from the hospital at home post-discharge. The studies either used one intervention or combined two or three interventions. We considered the intervention to improve patient safety or satisfaction when they reported statistically significant results. Only four interventions increased both patient safety and satisfaction, seven interventions increased patient safety and thirteen increased patient satisfaction. Interventions that appear to be quite similar, with the same duration, measured different effects on patients' satisfaction and safety. Interventions that ensured patient safety did not necessarily facilitate patient satisfaction and vice versa.

CONCLUSION

Interventions can improve patient safety and satisfaction during transfer. However, interventions that improve patient safety or satisfaction do not always match.

IMPACT

This review suggests that transition interventions can improve patients' safety and satisfaction. However, to compare the impact of future interventions is it important to use standardized measurement tools of satisfaction. There is a need to try out tailored interventions, where interventions are customized to the needs of each patient.

摘要

目的

本系统评价旨在描述和评估过渡干预措施的有效性,以保障患者在从医院到家庭医疗保健过渡期间的安全和满意度。

设计

系统评价。

资料来源

2019 年 1 月和 2020 年 9 月,系统检索了 MEDLINE、Ovid 护理数据库、PsycINFO、EMBASE、CINAHL 和 SveMed+,以确定同行评议文献。无语言、地理或出版日期限制。

评价方法

使用 Cochrane 干预措施系统评价手册。数据分析集中于汇总数据和描述性综合。使用 Cochrane 偏倚风险工具评估偏倚风险。

结果

文献检索共确定了 10524 条参考文献,纳入了 26 篇文章。干预措施分为三组:(i)系统的患者出院前教育;(ii)出院前与当地医疗保健服务建立联系;(iii)出院后由医院护士进行的随访。这些研究要么使用一种干预措施,要么组合使用两种或三种干预措施。我们认为,如果研究报告了统计学上显著的结果,则干预措施可提高患者的安全性或满意度。只有四种干预措施同时提高了患者的安全性和满意度,七种干预措施提高了患者的安全性,十三种干预措施提高了患者的满意度。看似非常相似的干预措施,具有相同的持续时间,对患者满意度和安全性的影响却不同。确保患者安全的干预措施不一定能促进患者满意度,反之亦然。

结论

干预措施可提高患者在转移过程中的安全性和满意度。然而,提高患者安全性或满意度的干预措施并不总是一致的。

影响

本综述表明,过渡干预措施可提高患者的安全性和满意度。然而,为了比较未来干预措施的影响,使用满意度的标准化测量工具非常重要。需要尝试定制化的干预措施,根据每个患者的需求定制干预措施。

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