在后急性和长期护理中微转换的最佳实践的障碍和促进者:混合方法研究
Aval-Na'Ree S Green1, Sing T Palat2, Kenneth S Boockvar3
1Department of Medicine, Baylor Scott and White Health, Central Texas Division, Temple, TX, USA; Department of Medicine, Baylor College of Medicine, Temple, TX, USA; Texas A&M University Health Science System College of Medicine, College Station, TX, USA.
Journal of the American Medical Directors Association
|October 4, 2025
概括
在后急性和长期护理 (PALTC) 中实施微转换的最佳实践是复杂的. 障碍包括员工负担和监管问题,阻碍在护理过渡期间的患者安全.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 老年学是一门学科.
背景情况:
- 微转换,即短暂的护理变化,在急性后和长期护理 (PALTC) 中经常发生.
- 这些转型带来了与主要转型类似的风险,如果不能适当管理.
- 在实施微转换的最佳实践方面,PALTC工作人员面临着挑战.
研究的目的:
- 探索在PALTC中实施微转换的最佳实践建议的障碍和促进因素.
- 确定影响微转换成功的患者,员工和系统级因素.
主要方法:
- 混合方法研究,涉及39名来自修改后的Delphi研究的小组成员.
- 通过3项调查和焦点小组收集的数据.
- 对障碍/促进者的反进行主题分析;内容分析和监管观点调查.
主要成果:
- 患者层面的主题:安全,居民权利. 工作人员层面的主题:负担,沟通,培训.
- 系统层面的主题:人员,法规,资源,责任.
- 大多数小组成员认为联邦/州法规是不必要的,但赞成更新的最佳实践建议.
结论:
- 成功执行微转换需要复杂的护理协调.
- 最佳实践可以减轻风险,但存在道德,责任和监管障碍.
- 目前的法规可能会阻碍而不是改善患者护理;需要对干预措施进行进一步的研究.
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