在急症医院的护理交付模式:一个多方法研究
Heather V Nelson-Brantley1, Bret Lyman, Esther Chipps
1Author Affiliations: Associate Professor, Director of Nurse Executive DNP Pathway, and Director of Nursing Health Systems Leadership MSN Pathway (Dr Nelson-Brantley), School of Nursing, University of Alabama at Birmingham; Professor (Dr Lyman), School of Nursing, Brigham Young University, Salt Lake City, Utah; Clinical Nurse Scientist and Professor of Clinical Nursing (Dr Chipps), The Ohio State University Wexner Medical Center, The Ohio State University College of Nursing, Columbus; Nurse Scientist (Dr Weaver), NJ Collaborating Center for Nursing and Ann May Center for Nursing, Hackensack Meridian Health, Neptune, New Jersey; Associate Professor (Dr Farag), College of Nursing, University of Iowa, Iowa City; Chief Nursing Officer (Dr Moore), MercyOne, Davenport, Iowa; Statistician (Dr Sinnott), The Ohio State University College of Optometry, Columbus; and Clinical Professor and Director of DNP & MSN Health Systems Administration and Executive Leadership Programs (Dr Joseph), College of Nursing, University of Iowa, Iowa City.
这项研究发现,初级护理是急性护理中最常见的护理模式 (CDM). 对CDM的变化往往是反应性的,是由人力资源短缺等因素驱动的,而不是战略规划.
科学领域:
- 医疗保健管理的管理
- 护理管理的护理管理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 急性护理机构面临着持续的挑战,包括劳动力短缺,运营效率低下和患者结果变化.
- 护理交付模型 (CDM) 对于组织医疗保健至关重要,但该领域的创新和研究有限.
- 了解当前的CDM及其变异性对于改善医疗保健服务至关重要.
研究的目的:
- 确定急性护理环境中普遍存在的护理交付模式 (CDM).
- 探索导致CDM在单位,医院和系统层面变化的因素.
- 分析影响护理模式变化的驱动因素.
主要方法:
- 采用多方法研究设计.
- 对294名护士领导进行了调查.
- 进行了34次定性访谈.
- 利用后勤回归和内容分析来识别影响因素.
主要成果:
- 初级护理成为最常见的CDM,被61.6%的参与者使用.
- 对CDM变革的关键驱动因素包括人员短缺,医院规模和领导角色.
- 在单位,医院和系统层面确定了不同的驱动类型.
结论:
- 在急性护理中,护理提供模式的调整往往是反应性的,缺乏战略或基于证据的基础.
- 识别组织驱动因素对于有意实施CDM至关重要.
- 为了有效评估护理交付模式,需要一致的指标.
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