一般实践中老年患者退院后护理的安全问题:一项民族学研究
Rachel Ann Spencer1, Zakia Shariff2, Jeremy Dale2
1Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry r.spencer.2@warwick.ac.uk.
概括
医院出院后的全科医院护理有很大的差异. 了解这些复杂的系统,包括处理出院总结,可以提高老年人多种药物和条件的患者安全.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 一般实践 一般实践
- 患者安全 患者安全
背景情况:
- 医院出院后是老年患者的高风险时期,特别是那些多药和多病症患者.
- 目前的一般实践护理和出院总结管理缺乏标准化,质量不同.
- 了解这些过程对于开发改善退院后护理的干预措施至关重要.
研究的目的:
- 了解和可视化在一般实践中对老年患者医院出院后持续护理的组织.
- 检查在一般实践中管理医院出院摘要所涉及的流程.
主要方法:
- 在英格兰西米德兰斯的10个普通诊所进行了一项快速民族学研究.
- 使用功能共振分析方法 (FRAM) 的系统建模用于绘制出院后护理过程.
- 数据收集涉及非正式对话,政策审查,直接观察,以及对现场笔记的解释性框架分析.
主要成果:
- 根据专业角色出现了三种不同的系统类型:全科医生主导,药剂师主导和行政主导.
- 确定的主要主题包括员工对行政要求的舒适性,全科医院团队动态和患者互动.
- 视觉表现突出了在医院出院后管理护理中的专业角色的复杂相互作用.
结论:
- 处理住院出院摘要的通用实践系统是复杂而多样化的.
- 一般实践中的新兴角色被广泛使用,通常需要大量的GP监督.
- 研究结果提供了关于不同退院后护理模式的安全特征,优势和局限性的见解.
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