「以病人為中心的專業照護合作模式」對腰椎椎間盤手術病人照護成效之探討

Measuring the Impact of a Patient-Focused Professional Collaborative Practice Model on HIVD Patient Outcomes

陳玉枝(Yu-Chih Chen) ； 林麗華(Li-Hwa Lin)

《新臺北護理期刊》 5卷1期 (2003/02) Pp. 71-82

https://doi.org/10.6540/NTJN.2003.1.007

摘要

The purpose of this study is to evaluated the effectiveness of care before and after the “patient-focused professional collaborative practice model” in a medical center was established. The study subjects were L-spine laminectomy patients confined in four neuro-surgical units from August 1, 2000 to July 31, 2001. The quasi-experimental study was performed to compare patient’s length of stay, quality of care and medical charges for L-spine laminectomy patients. Patients were divided into two groups-those who were cared for using the “patient-focused professional collaborative practice model” as an experimental group and those who were not, as a control group. Age (within 5 years) attending physician, surgical procedure and patient acuity matched the 30 controls. Retrospective chart review and medical charge data were used.
The results of this study were (1). average length of stay decreased 4 days form 10.6 days to 6.6 days (p＜0.05) after implementing patient-focused professional collaborative practice model; (2). medical charges decreased 8,492NT dollars (p＜0.05) from 76 338NT dollars for each patient. The four charge items (room charge, test and examination, treatment procedure and injection) were significantly decreased. (3). the quality of care as measured by rate of infection, unplanned readmission and complication was not significantly different between the two groups.
Based on these findings, recommendations will be made to enable policymakers and nurse administrators to develop the “patient-focused professional collaborative practice model” further, to improve the quality and effectiveness of patient care.

關鍵字

專業照護合作模式 ； 專科護理師 ； 照護成效 ； 住院天數 ； 成本效益

並列摘要

The purpose of this study is to evaluated the effectiveness of care before and after the “patient-focused professional collaborative practice model” in a medical center was established. The study subjects were L-spine laminectomy patients confined in four neuro-surgical units from August 1, 2000 to July 31, 2001. The quasi-experimental study was performed to compare patient’s length of stay, quality of care and medical charges for L-spine laminectomy patients. Patients were divided into two groups-those who were cared for using the “patient-focused professional collaborative practice model” as an experimental group and those who were not, as a control group. Age (within 5 years) attending physician, surgical procedure and patient acuity matched the 30 controls. Retrospective chart review and medical charge data were used.
The results of this study were (1). average length of stay decreased 4 days form 10.6 days to 6.6 days (p＜0.05) after implementing patient-focused professional collaborative practice model; (2). medical charges decreased 8,492NT dollars (p＜0.05) from 76 338NT dollars for each patient. The four charge items (room charge, test and examination, treatment procedure and injection) were significantly decreased. (3). the quality of care as measured by rate of infection, unplanned readmission and complication was not significantly different between the two groups.
Based on these findings, recommendations will be made to enable policymakers and nurse administrators to develop the “patient-focused professional collaborative practice model” further, to improve the quality and effectiveness of patient care.

並列關鍵字

professional collaborative practice model ； nurse specialist ； outcome of care ； length of stay ； cost effectiveness