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改善以患者为中心的护理终期脏病患者在社区息设置
概括
改善以患者为中心的护理对于患有末期脏疾病 (ESRD) 的老年人至关重要. 一个质量改进项目成功地在90天内将以患者为中心的ESRD患者的正确护理从24%提高到94%.
科学领域:
- 老年病的医生 老年病的医生
- 腎臟病學 (nephrology) 是一種醫學專業.
- 抚慰性护理是一种缓解性护理.
- 提高质量 提高科学 提高质量
背景情况:
- 末期病 (ESRD) 不成比例地影响65岁及以上的美国人,代表着日益增长的人口.
- 在这一群体中,高级护理规划的利用显著不足,只有不到10%的患者参与了这些关键的讨论.
- 一项图表审计显示,在息性ESRD患者中,关于预后,疾病负担,脏病协调和生命终端规划的沟通缺陷.
研究的目的:
- 增强对老年ESRD患者的以患者为中心的护理.
- 在90天的时间内,将以患者为中心的正确护理的提供率提高到80%.
- 改善患者参与和共享决策在缓解性ESRD管理.
主要方法:
- 在四个2周的快速周期中实施计划-做-研究-行动 (PDSA) 质量改进模型.
- 引入两个核心干预措施:对患者偏好/价值观的查和息管理的检查清单.
- 专注于两个关键的领域,在整个项目持续时间内进行改进.
主要成果:
- 对ESRD以患者为中心的正确护理从基线的24%显著增加到干预后的94%.
- 患者参与度得分在5分利克特等级上从3.2大幅上升至4.9.
- 这些干预措施支持了共享决策模式,增强了以患者为中心的护理.
结论:
- 该PDSA质量改进模型,加上有针对性的干预措施,有效地改善了患者为中心的护理对息性ESRD患者.
- 对患者偏好的查和使用标准化检查清单对于在ESRD息管理中提供正确的护理至关重要.
- 提高患者参与度和共享决策是可以实现和有益的结果在老年ESRD患者的护理.
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