实现最后的愿望:改善同情性释放过程
Rasidah Alias1, Yi Ling Neo2, Liyun Wang3
1Specialty Nursing, Changi General Hospital, Singapore rasidah_alias@cgh.com.sg.
BMJ open quality
|July 15, 2024
概括
怜悯性出院 (Compassionate Discharge,ComD) 是对绝症患者的紧急,快速出院. 一个新的资源包提高了ComD成功率,减少了家庭护理人员的焦虑,提高了终身护理.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 提高质量 提高质量
- 医疗保健管理的管理
背景情况:
- 富有同情心的出院 (Compassionate Discharges,简称ComD) 或快速出院,是为重症患者紧急转移到家中去世的方法.
- 由于利益相关者之间的流程意识和协调不佳,及时的ComD存在重大挑战.
- 康复症的延迟是常见的,影响患者和家庭在终身护理期间的体验.
研究的目的:
- 为了减少家庭护理人员的焦虑和延迟同情性出院过程.
- 试点一项质量改善 (QI) 计划,以加强ComD过程.
- 在12个月的时间内,保持ComD成功率高于90%.
主要方法:
- 过程映射,石川图和帕雷托图确定了设备采购和通信差距等障碍.
- 一个质量改进 (QI) 团队开发并试行了ComD资源包,包括检查清单,套件和护理人员资源.
- 三个计划-做-研究-行动 (PDSA) 周期被采用,以代地根据用户反来改进资源包.
主要成果:
- 在三个PDSA周期中,ComD的成功率增加了,在最后一个周期后达到96.7%.
- 在实施护理人员培训和资源后,观察到家庭护理人员焦虑的持续减少.
- 失败的同情性出院主要是由于急性临床恶化或延迟获得必要的家庭支持,如氧气.
结论:
- 开发的ComD资源包促进了跨学科的合作,提高了同情释放的安全性和有效性.
- 该倡议使更多的患者能够实现他们希望在他们喜欢的死亡地点实现死亡的愿望.
- 识别的QI问题和解决方案适用于各种医疗保健环境,突出了改善终身出院流程的普遍相关性.
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