High-Quality Nursing Home and Palliative Care-One and the Same.
High-Quality Nursing Home and Palliative Care-One and the Same.
复制标题
DOI：
10.1016/j.jamda.2021.11.027
复制
发表时间：
2022-03
影响因子：
7.6
通讯作者：
Stevenson DG
中科院分区：
文献类型：
--
作者：
Ersek M;Unroe KT;Carpenter JG;Cagle JG;Stephens CE;Stevenson DG
许多在疗养院接受急性后和长期护理服务的个人没有满足姑息治疗和临终关怀的需求。安宁疗护一直是满足这些需求的主要方法，尽管安宁疗护服务一般只提供给预后有限且选择放弃疾病改善或治愈性治疗的长期照护居民。满足这些需求的另外两种方法是通过以社区或医院为基础的项目和以设施为基础的姑息治疗服务提供姑息治疗咨询。然而，获得这种专门护理的机会有限，服务没有明确界定，而且这些方法有效性的经验证据不足。在本文中，我们回顾了这三种方法的现有证据和挑战。然后，我们描述了一个有效提供姑息治疗和临终关怀的模型，其中姑息治疗和临终关怀被视为高质量养老院护理的组成部分。为了实现这一愿景，我们提出了四项建议：1)通过全面的培训和支持，提高内部姑息治疗和临终关怀能力；2)确保州和联邦的支付政策和法规不会对提供高质量、以人为本的姑息治疗和临终关怀造成障碍；3)调整养老院质量措施，包括姑息治疗和临终关怀敏感指标；4)支持获取和整合外部姑息治疗服务。这些建议将要求在医疗服务的组织、提供和报销方面做出改变。所有的养老院都应该提供高质量的姑息治疗和临终关怀，本文描述了实现这一目标的一些关键策略。本文描述了目前的方法，证据，以及在养老院提供姑息治疗和临终关怀的挑战，并建议将这种护理整合到高质量的养老院护理中的策略。
Many individuals receiving post-acute and long-term care services in nursing homes have unmet palliative and end-of-life care needs. Hospice has been the predominant approach to meeting these needs, although hospice services generally are available only to long-term care residents with a limited prognosis who choose to forego disease-modifying or curative therapies. Two additional approaches to meeting these needs are the provision of palliative care consultation through community- or hospital-based programs and facility-based palliative care services. However, access to this specialized care is limited, services are not clearly defined, and the empirical evidence of these approaches’ effectiveness is inadequate. In this paper, we review the existing evidence and challenges with each of these three approaches. We then describe a model for effective delivery of palliative and end-of-life care in nursing homes, one in which palliative and end-of-life care are seen as integral to high quality nursing home care. To achieve this vision, we make four recommendations: 1) Promote internal palliative and end-of-life care capacity through comprehensive training and support; 2) Ensure that state and federal payment policies and regulations do not create barriers to delivering high quality, person-centered palliative and end-of-life care; 3) Align nursing home quality measures to include palliative and end-of-life care-sensitive indicators; and 4) Support access to and integration of external palliative care services. These recommendations will require changes in the organization, delivery, and reimbursement of care. All nursing homes should provide high-quality palliative and end-of-life care, and this paper describes some key strategies to make this goal a reality. This paper describes the current approaches, evidence, and challenges in delivering palliative and end-of-life care in nursing homes and recommends strategies for integrating this care into high quality nursing home care.
登录
查看更多内容
DOI：
10.3390/ijerph18020829
发表时间：
2021-01-19
影响因子：
--
作者：
Dupont C;De Schreye R;Cohen J;De Ridder M;Van den Block L;Deliens L;Leemans K
通讯作者：
Leemans K
DOI：
10.1377/hlthaff.2019.01549
发表时间：
2020-06
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Aldridge MD;Ornstein KA;McKendrick K;Moreno J;Reckrey JM;Li L
通讯作者：
Li L
影响因子：
4.4
作者：
Brandt, Hella E.;Ooms, Marcel E.;Ribbe, Miel W.
通讯作者：
Ribbe, Miel W.
影响因子：
6.3
作者：
Ersek, Mary;Thorpe, Joshua;Smith, Dawn
通讯作者：
Smith, Dawn
影响因子：
6.3
作者：
Cegelka, Aimee
通讯作者：
Cegelka, Aimee