COVID-19 大流行期间医院和护理院之间过渡相关的挑战和改进：一项针对英格兰护理院和医护人员的定性研究。

Challenges and improvements associated with transitions between hospitals and care homes during the COVID-19 pandemic: a qualitative study with care home and healthcare staff in England.

机构信息

Department of Social Work, Education & Community Wellbeing, Faculty of Health & Life Sciences, Northumbria University, Newcastle-upon-Tyne NE7 7XA, UK.

Newcastle University, UK.

出版信息

Age Ageing. 2023 Sep 1;52(9). doi: 10.1093/ageing/afad146.

DOI:10.1093/ageing/afad146

PMID:37740896

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10517646/

Abstract

BACKGROUND

Care home residents transitioning from hospital are at risk of receiving poor-quality care with their safety being challenged by the SARS-CoV-2 virus (COVID-19) pandemic. Little is known about how care home staff worked with hospital staff and other healthcare professionals to address these challenges and make improvements to increase patient safety.

OBJECTIVE

To gain insight into how the COVID-19 pandemic influenced the safety of transitions between hospital and care home.

METHOD

Semi-structured interviews were conducted with care home staff and healthcare professionals involved in hospital to care home transitions including doctors, nurses, paramedics, pharmacists, social workers, and occupational therapists. Commonalities and patterns in the data were identified using thematic analysis.

RESULTS

Seventy participants were interviewed. Three themes were developed, first, 'new challenges', described care homes were pressurised to receive hospital patients amidst issues with COVID-19 testing, changes to working practices and contentious media attention, which all impacted staff negatively. Second, 'dehumanisation' described how care home residents were treated, being isolated from others amounted to feelings of being imprisoned, caused fear and engendered negative reactions from families. Third, 'better ways of working' described how health and social care workers developed relationships that improved integration and confidence and benefited care provision.

CONCLUSION

The COVID-19 pandemic contributed to and compounded high-risk hospital-to-care home discharges. Government policy failed to support care homes. Rapid discharge objectives exposed a myriad of infection control issues causing inhumane conditions for care home residents. However, staff involved in transitions continued to provide and improve upon care provision.

摘要

背景

从医院转至养老院的患者面临着护理质量下降的风险，同时 SARS-CoV-2 病毒（COVID-19）大流行也对他们的安全构成了挑战。目前，人们对于养老院工作人员如何与医院工作人员和其他医疗保健专业人员合作以应对这些挑战并改善措施以提高患者安全性知之甚少。

目的

深入了解 COVID-19 大流行如何影响医院与养老院之间的交接安全。

方法

对参与医院至养老院交接的养老院工作人员和医疗保健专业人员（包括医生、护士、护理人员、药剂师、社会工作者和职业治疗师）进行半结构式访谈。使用主题分析识别数据中的共性和模式。

结果

共对 70 名参与者进行了访谈。确定了三个主题，首先是“新挑战”，描述了养老院在 COVID-19 检测、工作实践变化和有争议的媒体关注等问题下接收医院患者的压力，所有这些都对员工产生了负面影响。其次是“去人性化”，描述了养老院患者受到的待遇，将他们与他人隔离相当于被监禁，引起了恐惧，并引起了家属的负面反应。第三是“更好的工作方式”，描述了卫生和社会保健工作者如何建立关系，从而改善了整合和信心，并使护理服务受益。