由多学科团队成员在住院康复和熟练护理设施中识别的息护理需求的比较分析
Erin Kelly1, Elizabeth Spina2, John Liantonio3
1Department of Rehabilitation Medicine, Thomas Jefferson University Hospital, Philadelphia, PA.
Archives of physical medicine and rehabilitation
|June 18, 2023
概括
在住院康复设施 (IRF) 和熟练护理设施 (SNFs/LTC) 中,尽管已确定了患者的需求,但获得专业息治疗 (PC) 的机会是有限的. 解决员工的信念和系统障碍对于改善PC在急性后护理中的整合至关重要.
科学领域:
- 息护理研究 息护理研究
- 医疗保健的获取和提供
- 在急性病后的护理.
背景情况:
- 专门的息治疗 (PC) 对于在后急性环境中管理复杂的患者需求至关重要.
- 现有的PC服务可能无法充分解决住院康复设施 (IRF) 和长期护理技术护理设施 (SNF / LTC) 的多样化的患者群体.
- 了解与PC相关的需求,信念和障碍对于改善护理至关重要.
研究的目的:
- 评估医疗保健专业人员对专业化息治疗 (PC) 的可用性,需求和信仰.
- 为了比较IRF和SNF/LTC之间的息护理需求和员工信心.
- 为了确定后急性设置息护理咨询的障碍.
主要方法:
- 进行了一项观察性,比较性需求评估调查.
- 这项研究包括198名医疗保健专业人员,医生,护理人员,病例管理人员,社会工作者和精神护理提供者.
- 参与者来自四个IRF和SNF/LTC的第三级护理系统.
主要成果:
- 只有37%的受访者报告PC可用性;IRF有更高的未满足的悲伤/精神需求,而SNF/LTC报告了更多的终身护理需求.
- 与IRF工作人员相比,SNF/LTC工作人员报告说,与IRF工作人员相比,他们对管理终身护理,讨论PC/临终关怀,预先指示和伦理决策的信心更强.
- 对PC咨询的主要障碍包括员工/患者的信念,系统访问问题以及对PC角色缺乏理解.
结论:
- 在IRF和SNF/LTC内部,在息护理 (PC) 获取方面存在很大的差距,尽管患者的需求和支持性工作人员的信念得到了认可.
- 需要进一步的研究来确定最佳的患者转诊标准PC在后急性护理.
- 确定适当的结果措施对于指导PC服务在这些环境中的扩展至关重要.
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