系统地在养老院实施预先指示计划:一个随机对照试验
D W Molloy1, G H Guyatt, R Russo
1Department of Medicine, McMaster University, Ontario, Canada. molloy@mcmaster.ca
JAMA
|March 25, 2000
概括
系统地在养老院实施预先指示,减少了住院和医疗保健费用. 患者和家庭对决策和死亡率的满意度没有受到该计划的影响.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 生物伦理学生物伦理学
背景情况:
- 预先指令被广泛使用,但它们的系统实施效果被研究不足.
- 养老院居民往往有复杂的健康需求,需要明确的终身护理计划.
研究的目的:
- 评估一个系统地实施的预先指令程序在养老院的影响.
- 评估对患者和家庭对决策和医疗保健成本的满意度的影响.
主要方法:
- 在安大略省6个养老院进行了一项随机对照试验,持续了4年.
- 该干预涉及向工作人员,居民和家庭提供有关预先指示的教育.
- 在干预和控制护理院之间进行了对比,对满足感和资源利用进行了比较.
主要成果:
- 系统地实施预先指令导致住院病例显著减少,平均医疗保健费用降低.
- 两组之间的患者或家庭满意度水平没有显著差异.
- 干预和对照疗养院的死亡率相似.
结论:
- 系统的提前指令计划可以减少养老院的医疗保健利用率.
- 这些计划不会对患者/家庭的满意度或死亡率产生负面影响.
- 这种方法为改善长期护理机构的终身护理计划提供了一个可行的策略.
更多相关视频
相关概念视频
01:19Restorative Care
2.3K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.3K
01:24Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
2.1K
Planning for learning involves the development of a teaching plan. Teaching plans are similar to nursing care plans—both follow the steps of the nursing process. Planning in the teaching process involves setting goals and outcomes. Here, goals identify what a patient needs to achieve to understand a healthcare topic better, whereas the outcomes are the action to be performed by the patient to achieve the goal within a timeframe. For example, if the goal is to educate the patient about...
2.1K
01:21Planning Nursing Care I
5.7K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
5.7K
01:15Nursing Implementation
6.3K
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
6.3K
01:29Documentation in Long-Term and Home Healthcare Setting
1.5K
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
1.5K
01:19Standards of Care II
1.1K
Nurses bear specific legal responsibilities under several federal statutes, including:
1.1K