- 期刊
安寧病房執行出院準備服務計劃之改善方案
The Eastablishment of Discharge Planning in a Hospital-Based Palliative Care
摘要
本專案目的在探討安寧病房護理人員執行出院準備服務計劃之改善方案。本病房創立至今，曾多次設計出院準備服務執行方法，但效果不彰。當病人預備出院時，常面臨團隊的衝突及家屬的不安，約有五成的病人(51.2%)於出院當天，才開始準備居家輔具，甚至有些病人未及時調整藥物，而延長住院時間(25.0%)。經現況分析120份病歷資料，出院準備服務執行率僅佔38.3%。此專案藉由制定出院準備流程及修訂出院準備評估表，自2004年03月29日至2004年9月30日共6個月的執行時間。結果顯示，病人出院前三天出院準備執行率提昇至88.4%。其中，醫藥及輔助器材準備提昇至81.3%，藥物調整準備100%，有效達到本專案之目的。期望此專案之經驗能夠提供其他團隊之參考，讓末期病人得以獲得有計劃及持續性之照顧。
並列摘要
The purpose of this study was to investigate the establishment of discharge plan in a hospital-based Palliative Care Unit in Hualien, Taiwan. A retrospective survey was conducted from March, 2004 to September, 2004. There were 120 medical documents were reviewed and found that the only 46 nursing records had put discharge plan on record (38.3%). The standards of discharge planning and the discharge assessment tool were developed on March, 2004. The tool was established by six hospice nursing experts' opinions. In-service education and team meeting were conducted to improve the comprehensive service of discharge plan. After three months implementing this project, the result showed that the writing completion of discharge record has increased by 38.3% to 88.4%. It is importance to enhancing the hospice nurses' discharge service by team discussion to find out the appropriate methods and so to improve the quality of nursing care. Further research is needed to evaluate the effects of applying the discharge standards, especially in the quality of home care at the last stage of the patients' lives.