合作工作以解决养老院居民不适当的ED出勤问题
Mary McCarthy1, Patricia Sheahan2
1University Hospital Kerry, Tralee, Ireland marymcc5000@gmail.com.
BMJ open quality
|November 28, 2025
概括
一个质量改进项目通过实施息护理服务,减少了不适当的急诊部从住院护理设施 (RCF) 的转移. 这一举措改善了居民的护理,并降低了医疗保健成本.
科学领域:
- 老年医学 老年医学
- 抚慰性护理是一种缓解性护理.
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 预期寿命上升和社会隔离增加了住院护理机构 (RCF) 的人口.
- 高率的不适当的急诊室 (ED) 住院从RCFs压力医疗保健资源.
- 不恰当的入学被定义为在较低成本的设置足够的情况下的转移.
研究的目的:
- 减少不适当的急诊室 (ED) 从住院护理设施 (RCF) 到凯里大学医院 (UHK) 的转诊.
- 具体目标是在一定的时间框架内 (2024年3月至2025年5月) 从50%降至30%的不合适转诊率.
主要方法:
- 实施了一项具有SMART目标的质量改进项目 (QIP).
- 通过缓解性脆弱多学科团队引入标准化术语.
- 制定了关于复苏状态和治疗升级的沟通文件.
- 为RCF推出高级护士执业者 (ANP) 息护理服务,由息医学医生支持.
- 为RCF工作人员提供综合教育.
主要成果:
- 减少了RCF居民的每月ED出勤次数,从平均82人减少到50人.
- 从50%降低了不适当的出席率到31%.
- 收到绝大多数积极的利益相关者反.
- 为医疗服务实现了经济节约.
结论:
- 综合老年和息医学服务增强RCF工作人员的知识和护理途径.
- 标准化术语和替代护理模式改善了患者管理.
- 一个专门的ANP息护理服务确保居民在正确的环境中获得适当的护理.
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