摘要
目的探索新型家庭病床管理模式——MASTER管理模式,提高家庭医疗服务质量,减少家庭病床主要不良事件的发生,保障患者安全。方法选取2006年8月—2012年6月北京马家堡社区符合家庭病床建床条件且同意参加试验的家庭病床患者1 680例,采用随机数字表法将其随机分成两组,Ⅰ组820例和Ⅱ组860例。Ⅰ组采用MASTER管理模式进行强化管理,Ⅱ组进行标准化管理;调查两组家庭护理人员慢性病知识和护理技能的知晓率,同时跟踪监测两组不良事件发生的情况,比较两组患者的医疗费用、满意度。结果Ⅰ组和Ⅱ组护理前家庭护理人员高血压、糖尿病、正常生命体征、口腔护理、皮肤护理、患者安全体位、患者合理膳食、患者的搬运、家庭预防感染知识知晓率比较,差异均无统计学意义(P>0.05);护理后两组上述慢性病知识和护理技能知晓率比较,差异均有统计学意义(P<0.05)。Ⅰ组发生不良事件19起,发生率为2.32%;Ⅱ组发生不良事件81起,发生率为9.42%;两组比较差异有统计学意义(χ2=37.91,P<0.01)。Ⅰ组较Ⅱ组人均医疗费用降低,满意度升高(P<0.05)。结论家庭病床的建立,最大限度地满足社区居民尤其是行动不便患者的医疗护理需求,但家庭病床不良事件也应高度注意。MASTER管理模式引入三级医院医学专家参与巡诊、查床,使社区卫生服务团队人力资源得到优化,对家庭护理人员的护理教育得到加强,规范了家庭医疗行为,有利于减少家庭病床不良事件的发生,提高家庭医疗服务质量,值得进一步研究推广。
ObjectiveTostudyanewpatternoffamilywardmanagement,namelytheMASTERmanagement,inor-dertoimprovethequalityoffamilycareandreducetheincidenceofmajoradverseeventsoffamilywards.Methods 1680eligi-ble family ward patients from Majiapu Community who agreed to participate the experiment from August 2006 to June 2012 were selected and randomly divided into group Ⅰ（820 cases） and groupⅡ（860 cases） .The groupⅠwas given MASTER manage-ment and the group Ⅱwas given normal management .The awareness rate of chronic disease knowledge and nursing skills of the nursing people in the two groups were surveyed and the adverse events of the two groups were also monitored .The medical cost and satisfactory rate of the two groups were compared.Results Before nursing, the hypertension, diabetes, vital signs, oral care and skin care of the nursing people , and the awareness rate of patient′s safe position, patient′s rational diet, handling of the pa-tient and infection prevention of the two groups showed no statistically significant difference （ P 〉0.05 ） .After nursing , the awareness rate of chronic disease knowledge and nursing skills between the two groups showed statistically significant differences （P〈0.05） .19 adverse events occurred in group Ⅰ, with an incidence of 2.32%; 81 adverse events occurred in group Ⅱ, with an incidence of 9.42%, and the difference between the two groups was statistically significant （χ2 =37.91, P〈0.01）. Compared with the group Ⅱ, the medical cost in group Ⅰwas lower, but the satisfactory level was higher （P〈0.05）.Conclu-sion The establishment of family ward can largely meet the requirements of patients in community , especially those who are una-ble to move freely.However, the adverse events should also be attached great importance to .The introduction of MASTER man-agement and the visits and bed check of experts from top level hospitals can optimize the medical human resources in the communi -ty.It can also strengthen the education of family nursing people , which is conducive to reducing adverse events and improving the family care level.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第21期2513-2516,共4页
Chinese General Practice
关键词
社区卫生服务
家庭医疗保健服务
组织和管理
Communityhealthservices
Homecareservices
Organizationandadministration
