"坐下来解决":在长期护理中的冲突解决过程中扩大伦理咨询的机会
David N Hoffman1, Gianna R Strand1
1Bioethics Program, School of Professional Studies, Columbia University, New York, NY, USA.
概括
长期护理提供者经常面临护理冲突和家庭纠纷,往往没有正式的政策或道德支持. 提高争端解决策略和伦理资源的可访问性对于改善患者和工作人员的体验至关重要.
科学领域:
- 老年病的医生 老年病的医生
- 生物伦理学生物伦理学
- 医疗保健管理的管理
背景情况:
- 在长期和急性后护理环境中,护理冲突困境很普遍.
- 提供者经常扎在代孕指令和家庭对患者护理的分歧.
研究的目的:
- 确定美国长期护理中的护理冲突的频率和性质.
- 检查提供者响应策略和使用道德资源解决争端.
主要方法:
- 在线横截面调查对急性后和长期护理医学协会 (AMDA) 的成员进行.
主要成果:
- 接受调查的三分之二的医疗主管报告说,他们拒绝了代孕指令,71%的人管理了家庭冲突.
- 冲突经常涉及治疗决策和预先指示的解释;一半的设施缺乏正式的争端调解政策.
- 伦理咨询很少被使用,只有五名受访者寻求帮助.
结论:
- 在长期护理机构中,具有道德挑战性的护理冲突是常见的.
- 目前的设施程序不足以将伦理资源纳入实践中.
- 建议包括制定可行的政策,增加获得伦理服务的机会,提高员工技能,以便更好地解决终身护理问题.
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