实施多站点共享血液透析护理计划。

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES
David Green, Angela Pietrafesa, Marianne Reyes, Giada Donnini, Evelyn Gicana, Evelyn Nadurata, Juniya John, Jessica Ponting, Raji Srinivasan, Udaya Prabhakar Udayaraj
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引用次数: 0

摘要

接受中心血液透析(HD)的成人患者积极性较低,这与较差的治疗效果有关。共享血液透析护理(SHC)是一种干预措施,通过这种措施,患者可以获得支持,承担治疗过程中的部分工作,从而提高患者的积极性,促进更好的自我护理。该项目旨在提高牛津大学肾脏病中心覆盖区内七个血液透析中心中实施共享血液透析护理的比例。计划-实施-研究-行动(PDSA)循序渐进,首先在两个中央血液透析中心(第 1 和第 2 周期)实现变革,然后在第 3 和第 4 周期推广到五个卫星血液透析中心。在周期 1 中,工作人员通过问卷调查和教学课程探索并改变了对特需医疗服务的看法;在周期 2 中,工作人员与患者合作制作了宣传单和告示牌,以提高对特需医疗服务的认识和参与度。然后,在 PDSA 周期 3 和 4 中,将这些干预措施推广到其余的血液透析中心。其他干预措施包括让员工和患者参加虚拟培训课程;指定SHC "冠军";参与国家SHC论坛;修改电子病历,以监控患者SHC的机会,促进可持续的改变。每个月都会收集有关实施个体化健康护理的患者人数以及处于个体化健康护理能力不同阶段的患者人数的成果测量数据。2022 年 4 月,只有 4%(19/483)的中心血液透析患者进行了任何方面的特殊健康护理。到 2023 年 12 月项目结束时,这一比例已增至 43%(220/511)。每个血液透析中心的患者SHC能力和进行SHC的患者人数都有了显著和持续的增长。该项目表明,即使工作人员和患者缺乏基本的体外震荡治疗经验,也有可能实施、扩大和维持多地点体外震荡治疗计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementing a multisite shared haemodialysis care programme.

Adults receiving centre-based haemodialysis (HD) have low levels of patient activation which are associated with poorer outcomes. Shared haemodialysis care (SHC) describes an intervention whereby individuals are supported to undertake elements of their treatment to improve their activation levels and promote better self-care. This project aimed to increase the proportion of those performing SHC in seven HD centres within the Oxford Kidney Unit's catchment area. Sequential Plan-Do-Study-Act (PDSA) cycles effected change first in two central HD centres, in cycles 1 and 2, before rolling out to five satellite HD centres, in cycles 3 and 4. Cycle 1 explored and transformed staff perceptions regarding SHC using a questionnaire and teaching sessions while in cycle 2, staff partnered with patients to develop leaflets and noticeboards to improve awareness and participation. These interventions were then rolled out to the remaining HD centres in PDSA cycles 3 and 4. Other interventions included: Enrolling staff and patients in virtual training courses; designating SHC 'Champions'; engagement with a national SHC forum; and changes to the electronic patient record to enable the monitoring of patient SHC opportunity and to promote sustainable change. Outcome measurement data on the number of patients performing SHC and the number at different defined stages of SHC competency were captured monthly. In April 2022, only 4% (19/483) of those receiving centre-based HD performed any aspect of SHC. By the end of the project in December 2023, this had increased to 43% (220/511). There was a significant and sustained growth in the stage of patient SHC competency as well as the number of patients performing SHC in each HD centre. The project demonstrated that it is possible to implement, scale-up and maintain a multisite SHC programme even with little baseline staff and patient SHC experience.

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来源期刊
BMJ Open Quality
BMJ Open Quality Nursing-Leadership and Management
CiteScore
2.20
自引率
0.00%
发文量
226
审稿时长
20 weeks
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