Chicago Department of Public Health, 333 S State St #200, Chicago, IL 60604, United States of America.
University of Illinois Chicago, 1603 W. Taylor St., Chicago, IL 60612, United States of America.
Appl Nurs Res. 2023 Dec;74:151747. doi: 10.1016/j.apnr.2023.151747. Epub 2023 Oct 27.
The aim of this study is to explore experiences and perspectives of nurses and providers (e.g., physicians, medical directors, fellows, and nurse practitioners) on reducing preventable hospitalizations of nursing home (NH) residents in relation to interprofessional relationship and hospitalization decision-making process.
Preventable NH resident hospitalization continues to be a pressing public health issue. Studies show that improved interprofessional relationship may help reduce hospitalization, yet research on communication processes and interactions among different NH staff remains limited.
This is a qualitative descriptive study. Two focus groups were held with fourteen nurses and thirteen in-depth, qualitative interviews were conducted with providers from two Chicagoland NHs. Focus group sessions and interviews were transcribed, coded, and analyzed for common themes based on qualitative description method.
All study participants agreed that providers have the ultimate responsibility for hospitalization decisions. However, nurses believed they could influence those decisions, depending on provider characteristics, trust, and resident conditions. Nurses and providers differed in the way they experienced and conveyed emotions, and differed in key elements affecting hospitalization decisions such as structural or environmental factors (e.g., lacking staff and equipment at the facility, poor communication between the NH and hospitals) and interpersonal factors (e.g., characteristics of effective nurses or providers and the effective interactions between them).
Interpersonal factors, including perceived competence, respect, and trust, may influence NH hospitalization decisions and be targeted for reducing preventable hospitalizations of residents.
本研究旨在探讨护士和医务人员（如医生、医疗主任、研究员和执业护士）在与跨专业关系和住院决策过程相关的减少疗养院居民可预防住院方面的经验和观点。
疗养院居民可预防住院仍然是一个紧迫的公共卫生问题。研究表明，改善跨专业关系可能有助于减少住院，但关于不同疗养院工作人员之间的沟通过程和相互作用的研究仍然有限。
这是一项定性描述性研究。在两家芝加哥地区疗养院进行了两次焦点小组会议，并对来自两家疗养院的 13 名医务人员进行了 13 次深入的定性访谈。根据定性描述方法，对焦点小组会议和访谈进行转录、编码和分析，以确定共同主题。
所有研究参与者都同意，提供者对住院决策负有最终责任。然而，护士认为他们可以根据提供者的特点、信任和居民的情况来影响这些决策。护士和提供者在体验和表达情感的方式上存在差异，并且在影响住院决策的关键因素上存在差异，例如结构或环境因素（例如，机构缺乏人员和设备，疗养院和医院之间沟通不畅）和人际因素（例如，有效护士或提供者的特点以及他们之间的有效互动）。
人际关系因素，包括感知能力、尊重和信任，可能会影响疗养院的住院决策，并可针对减少居民的可预防住院进行针对性治疗。
