多站点指导实施方法的成果,以促进护理对话的目标
Gordon J Wood1, Rebecca K Clepp2, Jungwha Lee3
1Division of Hospital Medicine (G.J.W., A.O., J.N., E.S.), Section of Palliative Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Medical Education (G.J.W.), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of pain and symptom management
|May 2, 2024
概括
偏好一致的沟通和治疗 (PACT) 项目改善了重病患者的护理对话的目标. 这导致了与患者愿望一致的护理,并减少了生命终端资源利用.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 偏好信息与处理 (PACT) 项目是一个多站点倡议.
- PACT增加了严重疾病的住院患者的护理目标 (GOC) 对话.
研究的目的:
- 评估PACT项目的对目标不一致的护理的影响.
- 评估PACT对生命周期末期资源利用的影响.
主要方法:
- 医院为中国政府的对话实施了一项指导质量改善倡议.
- 通过将患者的愿望与Medicare索赔数据进行比较来评估护理不一致性.
- 使用Medicare索赔数据对干预组和对照组之间的终生资源利用率进行了比较.
主要成果:
- 干预组显示,与患者愿望不一致的护理率很低.
- 干预患者的成本更低,ICU入院减少,呼吸机或心肺复苏等干预措施更少.
- 干预组的患者更有可能入住临终关怀医院,并且在临终关怀医院停留时间更长.
结论:
- 对重病住院患者进行质量改善干预,使护理与患者目标保持一致.
- 该PACT项目有效地减少了生命周期结束的资源利用率.
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