Family and Provider Experiences With Longitudinal Care Coordination for Infants With Medical Complexity.
Family and Provider Experiences With Longitudinal Care Coordination for Infants With Medical Complexity.
复制标题
家庭和提供者对医疗复杂性婴儿进行纵向护理协调的经验。
DOI：
10.1097/anc.0000000000000998
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Foster,Carolyn
中科院分区：
文献类型：
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作者：
Dallas,Abbey;Ryan,Alexandra;Mestan,Karen;Helner,Khrystyna;Foster,Carolyn
背景：新生儿重症监护病房(NICU)的父母报告称，他们在管理孩子持续的医疗和社会需求方面缺乏自信。虽然床边护士在NICU入院期间为家庭提供关键支持，但在住院、出院和过渡到门诊护理的整个过程中，护理协调可能会发挥作用。目的：本计划评估旨在探索一种新的纵向护理协调计划的父母和提供者的经验，该计划针对从NICU到出院后第一年的医疗复杂性婴儿。方法：首先，采用顺序探索性混合方法评估父母的经验(n=5访谈，然后n=23调查)。通过半结构化访谈(n=8)和焦点小组(n=26分成3组)获得提供者的观点。结果：父母报告的好处包括频繁的沟通和个性化的支持，满足了家庭和患者不断变化的需求。护理协调员接受过护士和社会工作者的培训，与父母建立了纵向关系。这似乎有利于在生命的第一年提供个性化的支持。提供者报告说，较小的病例量是该计划成功的关键。实践和研究的影响：这种纵向护理协调计划可以作为其他NICU的可翻译模式，以满足患有医疗复杂性的婴儿家庭在生命第一年的独特需求。未来的实现应该考虑如何在保持个性化支持的同时扩大程序规模。由于护理协调员是前NICU护士和社会工作者，护理协调在新生儿人群中的作用可能会越来越大。
Background:Parents in the neonatal intensive care unit (NICU) report low self-confidence managing their children's ongoing medical and social needs. While bedside nurses provide critical support for families throughout their NICU admission, there may be a role for nursing coordination throughout hospitalization, discharge, and in the transition to outpatient care.Purpose:This program evaluation explores parent and provider experiences of a novel longitudinal care coordination program for infants with medical complexity from the NICU through their first year of life post-discharge.Methods:First, a sequential exploratory mixed-methods approach was used to evaluate parental experiences (n= 5 interviewed followed by n= 23 surveyed). Provider perspectives were elicited through semi-structured interviews (n= 8) and focus groups (n= 26 in 3 groups).Results:Parent-reported benefits included frequent communication and personalized support that met families' and patients' evolving needs. Care coordinators, who were trained as nurses and social workers, developed longitudinal relationships with parents. This seemed to facilitate individualized support throughout the first year of life. Providers reported that smaller caseloads were central to the success of the program.Implications for Practice and Research:This longitudinal care coordination program can be used as a translatable model in NICUs elsewhere to address the unique needs of families of infants with medical complexity throughout the first year of life. Future implementations should consider how to expand program size while maintaining individualized supports. As the care coordinators are former NICU nurses and social workers, there may be a growing role for nursing coordination of care in the neonatal population.