使用目标导向的护理计划指导方针,改善急性成人和老年人住院服务中职业治疗投入的以人为本的护理计划。

IF 1.6 Q4 HEALTH CARE SCIENCES & SERVICES
Joshua Jesudunsin Ige, Erica Screaton, Emily Jepson, Deborah Morgan, Oladayo Bifarin
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引用次数: 0

摘要

背景:以人为本的护理计划在精神卫生住院服务中至关重要,可确保患者目标与临床康复计划保持一致。尽管其公认的重要性,在急性住院设置的职业治疗师(OTs)往往面临的挑战,在实施结构化的,以人为中心的护理计划在入院10天内,基于门诊过程在急性住院服务。目标导向的护理计划(GDCP)框架以前在法医和康复环境中取得了成功,现在被引入,以改善OT对急性住院服务护理计划的投入。目的:本研究旨在通过实施GDCP框架,提高职业治疗护理计划的以人为本,目标是到2024年10月将职业治疗的贡献率从27.44%提高到70%。方法:采用多计划-研究-行动循环的质量改进方法,将GDCP框架嵌入3个住院病房。主要干预措施包括标准化OT护理计划输入,提供护理计划审计的内部培训,并确保及时记录患者目标和干预措施。每月进行审计,以评估进展情况并确定需要进一步改进的领域。结果:整体而言,护理计划的OT投入从27.44%(2023年6月- 10月)显著提高到53.25%(2023年11月- 2024年10月)。病区有所改善,T病区由24.42%上升至43.32%,M病区由37%上升至67.03%,P病区由21.09%上升至44.34%。改善的关键领域包括更明确的目标-行动联系和患者更多地参与护理计划。结论:实施GDCP框架提高了OT对护理计划贡献的质量和一致性,促进了一种更加结构化和结果驱动的方法。然而,需要解决持续存在的挑战,如劳动力短缺和外勤人员被分配到更安全的人员配置中的非专家角色,以维持以人为本的护理计划的改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving the person-centredness of occupational therapy input into care planning in acute adult and older adults' inpatient services using Goal-Directed Care Plan guidelines.

Background: Person-centred care planning is essential in mental health inpatient services, ensuring that patient goals align with clinical recovery plans. Despite its recognised importance, occupational therapists (OTs) in acute inpatient settings often face challenges in implementing structured, person-centred care plans within 10 days of admission based on the OT process within the acute inpatient services. The Goal-Directed Care Planning (GDCP) framework, previously successful in forensic and rehabilitation settings, was introduced to improve OT input into care plans in acute inpatient services.

Objective: This study aimed to enhance the person-centredness of occupational therapy care plans by implementing the GDCP framework, with a target of improving OT contributions from 27.44% to 70% by October 2024.

Methods: A quality improvement approach using multiple plan-do-study-act cycles was employed to embed the GDCP framework into three inpatient wards. Key interventions included standardising OT care-plan input, providing in-house training on care-plan audits, and ensuring timely documentation of patient goals and interventions. Monthly audits were conducted to assess progress and identify areas for further improvement.

Results: Across the board, OT input into care plans significantly improved from 27.44% (June-October 2023) to 53.25% (November 2023-October 2024). Ward-specific improvements were observed, with Ward T increasing from 24.42% to 43.32%, Ward M from 37% to 67.03% and Ward P from 21.09% to 44.34%. Key areas of improvement included clearer goal-action links and increased involvement of patients in care planning.

Conclusion: Implementing the GDCP framework enhanced the quality and consistency of OT contributions to care plans, fostering a more structured and outcome-driven approach. However, ongoing challenges such as workforce shortages and OTs being allocated to non-specialist roles in safer staffing need to be addressed to sustain improvements in person-centred care planning.

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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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