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聚焦衰弱的老年人医院护理强化项目(FrESH):一项混合方法研究,报告针对一线工作人员的专业教育效果

Frailty Focused Enhancements to Seniors' Hospital Care (FrESH): a Mixed Methods Study Reporting the Efficacy of Specialized Education for Front-line Staff.

作者信息

Peterson Jennifer E, Fowler Samantha A, Faig Karla J, Yetman Linda M, Feltmate Patrick J G

机构信息

Research Services, Horizon Health Network, Saint John, NB.

Maritime SPOR SUPPORT Unit, Halifax, NS.

出版信息

Can Geriatr J. 2025 Jun 4;28(2):145-153. doi: 10.5770/cgj.28.823. eCollection 2025 Jun.


DOI:10.5770/cgj.28.823
PMID:40463642
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12094085/
Abstract

BACKGROUND: Acute care hospital stays often lead to increased frailty and functional decline in older adults. Interventions such as specialized education for nurses can improve health outcomes and decrease lengths of stay for these patients. This study aimed to identify the facilitators and barriers to providing care to older adults in acute care, and the efficacy of specialized education for front-line staff. METHODS: A specialized education program for front-line staff, Frailty Focused Enhancements to Seniors' Hospital Care (FrESH), was developed and delivered across five family medicine units in New Brunswick (NB). A mixed methods approach was used to assess the knowledge, attitudes, and experiences of staff caring for hospitalized older adults, and evaluate the impact of providing specialized education. Patient-level data on delirium, mobility, and medications pre- and post-specialized education intervention were collected and analyzed. RESULTS: Sixty-three front-line staff participated. Analysis of questionnaires demonstrated that staff had positive attitudes and beliefs about caring for older adults; however, knowledge of geriatric care principles was limited and remained unchanged. There was no significant change in patient-level measures post-intervention. Environmental constraints hindered staff from implementing best practices, leading to practical challenges to care delivery. While respondents expressed satisfaction with the education, their capacity to deliver the type of care presented in the education sessions was not achievable. CONCLUSION: Staff identified the need for specialized education; however, there was no impact on care after participation. Results will inform changes to the specialized education programs targeting care for hospitalized older adults in acute care.

摘要

背景:急性护理医院住院常常导致老年人身体虚弱加剧和功能衰退。诸如为护士提供专业教育等干预措施可改善健康结局并缩短这些患者的住院时间。本研究旨在确定在急性护理中为老年人提供护理的促进因素和障碍,以及对一线工作人员进行专业教育的效果。 方法:为一线工作人员制定了一项专业教育计划,即老年人医院护理的虚弱重点强化(FrESH),并在新不伦瑞克省(NB)的五个家庭医学单位实施。采用混合方法评估照顾住院老年人的工作人员的知识、态度和经验,并评估提供专业教育的影响。收集并分析了专业教育干预前后患者层面关于谵妄、活动能力和用药情况的数据。 结果:63名一线工作人员参与。问卷调查分析表明,工作人员对照顾老年人持积极态度和信念;然而,老年护理原则的知识有限且未发生变化。干预后患者层面的指标没有显著变化。环境限制阻碍工作人员实施最佳实践,导致护理提供面临实际挑战。虽然受访者对教育表示满意,但他们无法实现教育课程中所呈现的护理类型的能力。 结论:工作人员认识到需要专业教育;然而,参与后对护理没有影响。研究结果将为针对急性护理中住院老年人护理的专业教育计划的变革提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b1/12094085/17303739748d/cgj-28-145f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b1/12094085/6758a16d1b54/cgj-28-145f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b1/12094085/17303739748d/cgj-28-145f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b1/12094085/6758a16d1b54/cgj-28-145f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b1/12094085/17303739748d/cgj-28-145f2.jpg

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本文引用的文献

[1]
Impact of Hospitalization on Patients Ability to Perform Basic Activities of Daily Living.

Can Geriatr J. 2023-12-1

[2]
Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide: A Systematic Review and Meta-Analysis.

JAMA Netw Open. 2023-8-1

[3]
A Systematic Review of Potentially Inappropriate Medications Use and Related Costs Among the Elderly.

Value Health Reg Issues. 2021-9

[4]
Lifelong learning and nurses' continuing professional development, a metasynthesis of the literature.

BMC Nurs. 2021-4-14

[5]
Using the Clinical Frailty Scale in Allocating Scarce Health Care Resources.

Can Geriatr J. 2020-9-1

[6]
Can the effects of the mobilization of vulnerable elders in Ontario (MOVE ON) implementation be replicated in new settings: an interrupted time series design.

BMC Geriatr. 2019-4-5

[7]
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Can Fam Physician. 2019-1

[9]
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BMC Geriatr. 2018-6-11

[10]
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Arch Gerontol Geriatr. 2018-5-17

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