出院后的护理人员辅助社区评估:PACED干预
Laurel O'Connor1, Stephanie Sison2, Kimberly Eisenstock2
1Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Journal of the American Medical Directors Association
|July 20, 2024
概括
移动综合健康 (MIH) 计划可以减少脆弱的老年人重新入院. 这项试点研究表明,高可行性和初步证据表明,接受MIH护理人员过渡护理的患者的再入院减少.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 脆弱的老年人的早期再住院带来了重大风险和挑战.
- 移动综合医疗 (MIH) 为基于社区的过渡性护理提供了一个潜在的解决方案.
研究的目的:
- 评估一项MIH过渡期护理计划的可行性和实施情况,以对脆弱的老年人进行医院出院后的护理.
- 评估MIH过渡护理对再住院和急诊室 (ED) 访问的影响.
主要方法:
- 一个试点临床试验,涉及到MIH护理人员在医院出院后72小时内进行家庭访问.
- 符合条件的参与者是65岁以上的成年人,具有高的eFrailty指数,与地理上排除的对照组相比.
- 主要结果是可行性和实施;次要结果包括30天ED访问和再住院率.
主要成果:
- MIH过渡期护理计划 (PACED) 是可行的,协议忠实度为92%.
- 护理人员在大量的访问中确定了临床问题,请求了服务,并发现了药物错误.
- PACED组显示30天再入院的风险显著降低 (RR 0.40,P=.03) 和减少急救诊所访问的趋势.
结论:
- MIH过渡期护理计划是可行的,并且在实施中表现出高度的忠实性.
- 初步证据表明,MIH计划可以降低脆弱老年人的再住院率.
- 这项研究支持进一步调查MIH作为退院后过渡期护理的模型.
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