在养老院护理中的系统性失败 - - 一项范围研究
Joachim P Sturmberg1,2, Len Gainsford3,4, Nicholas Goodwin5
1College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia.
Journal of evaluation in clinical practice
|January 23, 2024
概括
养老院的系统性失败源于不明确的目的和治理. 解决这些问题对于改善护理质量,居民满意度和老年护理机构工作人员经验至关重要.
科学领域:
- 老年学和医疗服务研究研究
- 组织研究 组织研究
- 公共政策 公共政策
背景情况:
- 养老院或住宅老年护理设施面临着全球性的挑战,需要平衡居民需求,监管要求和财务要求.
- 这种系统紧张往往导致对设施的核心目的缺乏清晰度,可能会导致所有组织层面的功能障碍.
研究的目的:
- 进行一项范围研究,综合现有关于养老院部门系统功能和故障的知识.
- 分析这些系统性问题对更广泛的健康和老年护理环境的影响.
主要方法:
- 搜索了MEDLINE,EMBASE,PSYCHINFO,CINAHL和SCOPUS的系统专注文章,直到2021年2月.
- 包括引用的雪球和灰色文献搜索.
- 定义以系统为中心的文章是那些检查跨层次影响或在同一层面对多个代理商的影响的文章.
主要成果:
- 分析了美国,加拿大,澳大利亚和欧洲的38篇文章,在五个层面上确定了29个关键的系统问题.
- 发现只有四项研究报告了整个系统的发现.
- 负面结果包括监管指责,居民/家庭/工作人员的不满,以及对养老院作为工作场所的负面看法.
结论:
- 养老院的关键系统问题源于缺乏共同目标和国家治理/问责框架不足.
- 重新设计养老院系统需要解决这些核心问题,以实现整合和希望的居民结果.
- 实施"系统思维"对于同时提高护理质量,加强监管和确保财务可行性至关重要.
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