预先指示在养老院居民中经常发生变化
Hannah J Wong1, Hsien Seow2, Anastasia Gayowsky3
1School of Health Policy & Management, York University, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada.
Journal of the American Medical Directors Association
|June 17, 2024
概括
预先指示 (AD) 的变化在养老院中是动态的. 频繁的AD审查,特别是在健康变化后,对于准确的护理规划和遵守至关重要.
科学领域:
- 老年学和老年医疗护理
- 医疗保健服务研究 医疗服务研究
- 抚慰性护理是一种缓解性护理.
背景情况:
- 预先指示 (ADs),包括不要复苏 (DNR) 和不要住院 (DNH) 命令,指导养老院的终身护理.
- 了解AD变化的模式和频率对于确保居民愿望得到尊重至关重要.
研究的目的:
- 描述在预先指令 (ADs) 中的变化速度,时间和模式,在新入院养老院中,不要复苏 (DNR) 和不要住院 (DNH) 的订单.
- 在这个人群中确定与AD变化相关的因素.
主要方法:
- 在加拿大安大略省 (2013-2017) 的102,541个养老院入院者的回顾性队列研究.
- 居民分为全代码,仅DNR或DNR+DNH组.
- 波桑回归用于分析AD变化,控制临床和社会人口统计学变量.
主要成果:
- 46%的全代码,30%的DNR只有,和25%的DNR+DNH居民经历了至少一个AD变化.
- 从第一个AD变化到第一个AD变化的中位时间从26周到55周不等.
- 在入院时有DNR命令或代理决策者的居民的AD变化率较低.
结论:
- 附加值是动态的,静态测量低估了变化,可能会误解护理效率.
- 建议更频繁的AD审查,特别是在急性健康变化后,以确保货币.
- 动态AD评估对于准确的住院护理规划和遵守偏好至关重要.
相关概念视频
Standards of Care II
640
Nurses bear specific legal responsibilities under several federal statutes, including:
640
Ethical Issues
907
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
907
Documentation in Long-Term and Home Healthcare Setting
878
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
878
Legal Guidelines for Documentation
1.3K
The legal guidelines for nursing documentation are essential for ensuring accurate, professional, and ethical recording of patient care. The guidelines are discussed here:
1.3K
Nursing Ethical Principles II
952
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
952
Guidelines and Strategies for Safe Computer Charting
798
The guidelines and strategies provided by the American Nurses Association (ANA) and the Canadian Nurses Association (CNA) offer essential principles for ensuring safe and secure computer charting systems in healthcare settings. Let's break down each recommendation:
Maintain Confidentiality and Security:
Maintain Confidentiality and Security:
798


