Philp I, Goddard A, Connell N A, Metcalfe A, Tse V, Bray J
Department of Geriatric Medicine, University of Southampton, Southampton General Hospital.
Age Ageing. 1994 Mar;23(2):150-3. doi: 10.1093/ageing/23.2.150.
The aim of this study was to develop and evaluate an information system for monitoring impact of acute hospital care on health status of elderly patients, burden on carers, and consumer satisfaction with care. The study was undertaken on four acute care wards of an elderly care unit of a teaching hospital. We used a consensus-building process to achieve within-and-between-team convergence of policy and practice in the use of structured assessments on three wards, with parallel data collection by a research nurse on one ward. We describe the changes to our working practices, the costs of data collection, staff attitudes to the system and the assessment instruments, using 5-point Likert Scales, with additional in-depth interviews with senior staff for their attitudes to the system. We found that only nursing staff were able to change their practice. On admission, it was feasible to undertake functional assessment of activities of daily living (ADL), depression, perceived life quality and carer strain. Discharge assessment was only feasible for ADL. Other discharge assessments and follow-up assessments including consumer satisfaction interviews required audit assistant support. The total annual cost per ward was 6,225 pounds for the adopted system, or 6,455 pounds to incorporate follow-up assessments by audit assistant in a random sample of 50 patients. Staff attitudes to the system were positive, especially for use of the Relatives' Stress Scale, and for the value of follow-up interviews. We conclude that the participatory approach to the introduction of the information system produced a system which was perceived to be beneficial for patient care.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是开发并评估一个信息系统，用于监测急性医院护理对老年患者健康状况、护理人员负担以及患者对护理满意度的影响。该研究在一家教学医院老年护理单元的四个急性护理病房进行。我们采用了一种达成共识的过程，以使三个病房在使用结构化评估方面实现团队内部和团队之间政策与实践的趋同，同时由一名研究护士在一个病房进行平行数据收集。我们使用5分制李克特量表描述了工作实践的变化、数据收集成本、工作人员对该系统和评估工具的态度，并对高级工作人员就他们对该系统的态度进行了额外的深入访谈。我们发现只有护理人员能够改变他们的实践。入院时，对日常生活活动（ADL）、抑郁、感知生活质量和护理人员压力进行功能评估是可行的。出院评估仅对ADL可行。其他出院评估和随访评估，包括患者满意度访谈，需要审计助理的支持。采用的系统每个病房每年的总成本为6225英镑，若在50名患者的随机样本中纳入审计助理进行的随访评估，则每个病房每年的总成本为6455英镑。工作人员对该系统的态度是积极的，特别是对亲属压力量表的使用以及随访访谈的价值。我们得出结论，引入信息系统的参与式方法产生了一个被认为对患者护理有益的系统。（摘要截短为250字）
