在急诊室为认知障碍患者的护理伙伴提供密集支持的计划:随机对照试验
Joshua Chodosh1, Nicole R Fowler2, Anthony J Perkins3
1Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
概括
对于认知障碍患者来说,急诊室的访问往往来自未满足的需求. 一项研究发现,通过根源原因分析进行的痴呆症护理管理并没有显著减少老年人的急诊室再访.
科学领域:
- 老年学是指老年学的学科.
- 认知障碍研究 认知障碍研究
- 紧急医疗 紧急医疗
背景情况:
- 认知障碍患者的急诊室 (ED) 访问经常与未满足的护理需求有关.
- 确定有效的干预措施以减少这种脆弱人群的重复ED访问对于改善护理质量和降低医疗保健成本至关重要.
研究的目的:
- 评估痴呆症护理管理的有效性,根据ED访问的根源原因分析,在认知障碍的老年人中减少再访率.
- 评估认知查在ED环境中的可行性和影响.
主要方法:
- 一项随机对照试验,涉及75岁及以上的患者,在学术ED中通过查工具 (Mini-Cog或IQCODE) 检测出认知障碍.
- 参与者被分配到一个为期6个月的痴呆症护理管理计划或常规护理,干预措施以ED访问触发因素的根本原因分析为指导.
- 逻辑回归被用来比较干预和通常护理组之间的ED复诊率,在6个月的时间内.
主要成果:
- 在632个二中,有40.5%的患者在6个月内至少经历过一次ED复诊.
- 在痴呆症护理管理组和常规护理组之间,ED复诊率没有显著差异.
- 护理伙伴激活,抑郁或焦虑症状在3个月或6个月之间没有显著的群体间差异.
结论:
- 根据ED访问的根源原因分析,痴呆症护理管理策略并没有导致认知障碍的老年人重新访问ED的减少.
- 虽然在ED中进行认知查是可行的,以提高质量,但它可能无法充分识别需要重症监护管理的所有二.
- 个性化,基于需求的查和护理管理方法可能更有效地针对认知障碍的ED患者,并解决他们访问的根本原因.
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