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通过为体弱老年人采用预防性护理流程进行护理协作的障碍与机遇:一项混合方法研究设计的研究方案

Obstacles and opportunities for care collaboration through the utilisation of a preventive care process for frail older adults: a study protocol for a mixed methods study design.

作者信息

Boström Martina Karin, Larsson Ranada Åsa, Wijk Helle, Skott Pia, Erichsen Anette, Rothenberg Elisabet

机构信息

Department of Quality Improvement and Leadership, Jönköping Academy For Improvement of Health and Welfare, Jönköping University Hälsohögskolan, Jonkoping, Sweden

Qulturum, Region Jönköpings län, Jönköping, Sweden.

出版信息

BMJ Open. 2025 Feb 10;15(2):e081925. doi: 10.1136/bmjopen-2023-081925.

Abstract

BACKGROUND

Frail older adults constitute a significant vulnerable group with complex healthcare needs requiring collaboration between various care providers and professions. Despite this requirement, there are considerable knowledge gaps in how to achieve effective collaboration. Preventive measures such as addressing pressure ulcers, falls, malnutrition and poor oral health often receive low priority compared with treating diseases or injuries. This study aims to enhance our understanding of how care collaboration in the preventive care process (PcP) using the Senior alert (SA) register could improve patient safety and equality of care for frail older adults in Sweden.

METHODS

This study, conducted over 4 years, employs an explanatory mixed methods design, divided into three phases. The study protocol comprises the two first phases. PHASE 1 QUANTITATIVE: Data from SA (2019-2021) will be analysed to compare municipalities regarding the quality of registration in the PcP. Municipalities with high and low compliance indices will be identified and analysed together with data on demographics, socioeconomics and organisation from Statistics Sweden. PHASE 2 QUALITATIVE: Focus group interviews will be conducted in residential care units in the municipalities identified in phase 1 with interprofessional teams and older persons/next of kin. Additionally, 30 semi-structured individual interviews with residential care managers and other relevant stakeholders will explore obstacles and opportunities for effective care collaboration.

DISCUSSION

We foresee that the results will contribute to the development of a model for effective PcP and care collaboration that can be used to improve patient safety and quality of care for frail older adults. This model can be tested and upscaled to achieve a more effective and equitable healthcare system.

ETHICS AND DISSEMINATION

The study has been approved by the Swedish ethical review authority. Dissemination plans involve publications, data deposition and engagement with healthcare stakeholders to ensure the practical application of the findings.

摘要

背景

体弱的老年人是一个重要的弱势群体,有着复杂的医疗保健需求,这需要不同护理提供者和专业之间的协作。尽管有此需求,但在如何实现有效协作方面仍存在相当大的知识差距。与治疗疾病或损伤相比,诸如解决压疮、跌倒、营养不良和口腔健康不佳等预防措施往往得不到应有的重视。本研究旨在加深我们对使用“高级警报”(SA)登记册在预防性护理过程(PcP)中进行护理协作如何能够提高瑞典体弱老年人的患者安全和护理公平性的理解。

方法

本研究历时4年,采用解释性混合方法设计,分为三个阶段。研究方案包括前两个阶段。第一阶段(定量研究):将分析SA(2019 - 2021年)的数据,以比较各市政当局在PcP中的登记质量。将确定并分析合规指数高和低的市政当局,并结合瑞典统计局提供的人口统计学、社会经济学和组织数据进行分析。第二阶段(定性研究):将在第一阶段确定的市政当局的寄宿护理单位中,与跨专业团队以及老年人/亲属进行焦点小组访谈。此外,对寄宿护理经理和其他相关利益相关者进行30次半结构化个人访谈,将探讨有效护理协作的障碍和机会。

讨论

我们预计,研究结果将有助于开发一种有效的PcP和护理协作模式,可用于提高体弱老年人的患者安全和护理质量。该模式可进行测试并扩大规模,以实现更有效和公平的医疗保健系统。

伦理与传播

本研究已获得瑞典伦理审查机构的批准。传播计划包括发表论文、数据存档以及与医疗保健利益相关者合作,以确保研究结果的实际应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dfa/11815419/c77d09fd9be9/bmjopen-15-2-g001.jpg

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