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首页> 外文期刊>Journal of advanced nursing >Practice nurses and older people: a case management approach to care.
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Practice nurses and older people: a case management approach to care.

机译：练习护士和老年人：案例管理方法。

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AIM: This paper reports on aspects of a study designed to answer the research questions: (i) To what extent do practice nurses use the five cyclical elements of a case management approach when caring for people aged over 75 years? (ii) What determines or deters practice nurses' use of the cyclical elements of a case management approach in caring for older people? BACKGROUND: Case management is an approach that uses a cyclical process of assessment, planning, implementation, monitoring and evaluation to provide systematic proactive care to people with complex health and social care needs. In England, specialist practice nurse case managers for older people have been piloted in ten primary care trusts and the posts are to be implemented nationally by 2008. No baseline work has, however, considered the applicability of developing the existing generalist practice nurse workforce. METHOD: A 26-item structured postal questionnaire was used to explore both practice nurses' use of a case management approach when working with older people, and what factors influenced the care provided. A random sample of 500 practice nurses was selected from the Royal College of Nursing Practice Nurse Association member database. RESULTS: A 45% response rate was achieved. Practice nurses assessed, planned and implemented care, but reviewing medication opportunistically and evaluating the care were uncommon. A case management approach was significantly (P = 0.005) more likely to be used in on-going management activities than in one-off treatment room care. Practice nurses with postregistration education in district nursing were significantly (P = 0.016) more likely to refer patients to social care services. Lack of time and the central role of the general practitioner were the main reasons for not incorporating case management into practice. CONCLUSIONS. The extent to which practice nurses used elements of a case management approach was highly variable and influenced by individual professional expertise, the nature of the consultation and the practice nurse's position in the general practice.
机译：目的：本文报告了旨在回答研究问题的一项研究的各个方面：（i）在护理75岁以上的人时，执业护士在多大程度上使用病例管理方法的五个周期性要素？ （ii）是什么决定或阻止执业护士在照顾老年人时使用案件管理方法的周期性要素？背景：病例管理是一种使用评估，计划，实施，监测和评估等周期性过程为有复杂健康和社会护理需求的人们提供系统的主动护理的方法。在英格兰，针对老年人的专科执业护士案例管理人员已在十个初级保健信托基金中进行了试点，该职位将于2008年在全国范围内实施。但是，没有基线工作考虑过发展现有的通才执业护士队伍的适用性。方法：使用26项结构化的邮政调查表来探讨实践护士在与老年人一起工作时对病例管理方法的使用，以及哪些因素影响所提供的护理。从皇家护理实践护士协会会员数据库中随机选择500名实践护士。结果：达到了45％的响应率。执业护士对护理进行了评估，计划和实施，但很少机会进行药物审查和评估。在持续的管理活动中，与一次性治疗室护理相比，采用病例管理方法的可能性显着（P = 0.005）。在地区护理中接受过注册后教育的执业护士显着（P = 0.016）更有可能将患者转介到社会护理服务部门。缺乏时间和全科医生的核心作用是未将案件管理纳入实践的主要原因。结论。执业护士使用案件管理方法要素的程度是高度可变的，并受个人专业知识，咨询性质和执业护士在一般执业中的职位的影响。

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