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首页> 外文期刊>International journal of older people nursing >From health organization-centred standardization work process to a personhood-centred care process in an Italian nursing home: effectiveness on bowel elimination model.
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From health organization-centred standardization work process to a personhood-centred care process in an Italian nursing home: effectiveness on bowel elimination model.

机译：从以卫生组织为中心的标准化工作流程到意大利养老院中以人为本的护理流程：排便模型的有效性。

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AIMS: An Italian nursing home's standardized work process redesign towards a personhood-centred nursing care is the focus of this study. The aim was to develop and implement a multi-method, personhood-centred, bowel elimination programme, to reduce the number of patients suffering from constipation and lessen the use of the invasive practises routinely adopted in nursing home (laxatives, enemas, rectal exploration). BACKGROUND: Although the importance of the application of personhood-centred care concepts in gerontology nursing has been widely recognized, the actual tendency of the Italian National Health System, which has few nursing resources for to the care of the older persons, is standardization. Standardization is enacted mainly by a functional pattern and carries the risk of using the same nursing answer to patient's different needs, priorities, preferences and histories. Constipation in older people living in nursing homes is one of the effects of extreme standardization. METHODS: A case-crossover study design was adopted from 2006 to 2007. Twenty persons were enrolled in the programme. The multi-method programme included three phases: assessment (first phase), development/implementation (second) and evaluation (third phase). RESULTS: In the first phase, nine (45%) persons were constipated; in the third phase, only two (10%) were constipated (chi(2) 6.14, P = 0.013). The relative risk of being a constipated person in the first phase compared with the third phase was 4.5 (confidence interval 95%: 1.11-18.27). During the first phase 562 invasive procedures were observed (+/- 25.5, range: 2-85) for bowel elimination whereas during the third phase 120 were observed (+/- 12, range: 0-58). CONCLUSION: After the personhood-centred multi-method programme, seven persons have modified their bowel elimination pattern, and they were no longer constipated. The programme has also reduced the use of invasive procedures. The reduction of invasive practises might have affected positively the persons' quality of life, their comfort and also the workload of the nurses, reducing the time they needed for constipation management and using it for prevention strategies.
机译：目标：意大利养老院的标准化工作流程重新设计，以人为本的护理是本研究的重点。目的是制定和实施以人为本的多方法排便计划，以减少便秘患者的数量，并减少在疗养院常规采用的侵入性做法（泻药，灌肠，直肠探查） 。背景：尽管以人为本的护理概念在老年医学护理中的重要性已得到广泛认可，但是意大利国家卫生系统的实际趋势是标准化的，该系统缺乏用于老年人护理的护理资源。标准化主要是通过功能模式制定的，并且存在针对患者的不同需求，优先事项，偏好和历史使用相同护理答案的风险。住在养老院的老年人便秘是极端标准化的影响之一。方法：从2006年至2007年采用了病例交叉研究设计。该方案招募了20人。多方法计划包括三个阶段：评估（第一阶段），开发/实施（第二阶段）和评估（第三阶段）。结果：在第一阶段，有九名患者（45％）发生便秘。在第三阶段，只有两个（10％）便秘（chi（2）6.14，P = 0.013）。与第三阶段相比，第一阶段成为便秘者的相对风险为4.5（置信区间95％：1.11-18.27）。在第一阶段，观察到有562种侵入性手术（+/- 25.5，范围：2-85）消除了肠，而在第三阶段，观察到了120种侵入性过程（+/- 12，范围：0-58）。结论：以人为本的多方法治疗方案后，有七个人改变了排便方式，不再便秘。该计划还减少了侵入性程序的使用。减少侵入性行为可能会积极影响人们的生活质量，他们的舒适度以及护士的工作量，减少他们进行便秘管理所需的时间并将其用于预防策略。

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