通过提供者教育和工作流程重新设计,改善初级保健的预先护理计划完成
Sanjib Dey1, Kathleen M Shurpin
1Graduate Department, School of Nursing, Stony Brook University, Stony Brook, NY.
Journal of the American Association of Nurse Practitioners
|February 3, 2026
概括
通过有针对性的教育和对文化敏感的宣传,提前护理计划 (ACP) 的完成改善了初级护理. 这项质量改善计划成功地吸引了各种患者,确保了他们的终身护理偏好得到了记录.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 以患者为中心的护理
- 健康差异 在健康上的差异
背景情况:
- 预先护理规划 (ACP) 使患者能够沟通未来的医疗偏好,调整终身护理和减少干预.
- 由于系统性障碍和沟通挑战,低水平的ACP毕业率仍然存在,特别是在服务不足和语言多样化的人口中.
研究的目的:
- 提高多站点初级保健环境中的预先护理计划 (ACP) 完成率.
- 解决不同患者群体在ACP参与和记录方面的差异.
主要方法:
- 一项质量改进计划利用诺尔斯的成人学习理论来提供提供者教育,以及计划-做-学习-行动循环来改进工作流程.
- 提供者和医疗助理接受了有针对性的教育,使用了标准化脚本,并使用了多语言材料来参与患者.
- 在六个月的两周一次图表审计中,监测了ACP的讨论和文档.
主要成果:
- 在150名慢性护理管理患者中,有76人完成了ACP文件,所有人都指定了医疗保健代理人.
- 在辅助教育课程之后,非洲和非洲的完成率有所增加.
- 多语言材料,标准化脚本和工作流适应是患者参与的关键促进因素.
结论:
- 针对性提供者教育,结构化工作流程和文化敏感的外展显著提高了在初级保健中ACP完成的水平.
- 护士是ACP的组成部分,促进患者的参与,记录,并确保文化和语言上适当的护理.
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