Home nursing for children with home mechanical ventilation in the United States: Key informant perspectives.
Home nursing for children with home mechanical ventilation in the United States: Key informant perspectives.
复制标题
DOI：
10.1002/ppul.25078
复制
发表时间：
2020-12
影响因子：
3.1
通讯作者：
Agrawal RK
中科院分区：
文献类型：
--
作者：
Sobotka SA;Dholakia A;Berry JG;Brenner M;Graham RJ;Goodman DM;Agrawal RK
患有家庭机械通气 (HMV) 的儿童需要训练有素的护理人员的熟练护理，他们的家人感受到了普遍存在的家庭护理短缺的影响。目前尚不清楚哪些因素决定分配；不存在私人护理强度的标准。我们试图描述提供者对 HMV 儿童家庭护理的经验和看法，假设提供者会描述临床场景中常见的家庭护理差距。有目的的滚雪球抽样确定了关键的临床提供者。调查主题包括在临床和家庭场景中接受家庭护理的时间。使用描述性统计数据和经过迭代修改以达成主要主题一致的开放式问题来分析封闭式回答。共有 59 名受访者代表来自 44 个州的患者护理人员； 49.2% 是医生，37.3% 是护士，10.2% 是呼吸治疗师，3.4% 是病例管理员。几乎所有人 (97%) 认为家庭在最初的家庭过渡期间应该获得更多的工作时间，但只有不到一半 (47%) 这么认为。大多数人 (80.7%) 认为家里有其他孩子会影响哺乳时间，但只有三人 (5.3%) 报告其他孩子有影响。在假设的医疗技术场景中，提供者一致描述儿童接受的护理时间少于提供者的理想实践。三分之一（31.7%）的人描述在没有安排任何家庭护理的情况下让病人出院。该 HMV 提供者样本凸显了家庭护理服务中普遍存在的缺陷，并对理想家庭护理的构成存在不同的解释。在护理分配中很少考虑家庭和社会背景因素。提供者、社区卫生和家庭利益相关者必须合作制定针对 HMV 儿童的国家社区实践标准。
Children with home mechanical ventilation (HMV) require skilled care by trained caregivers, and their families feel the impacts of ubiquitous home nursing shortages. It is unknown which factors determine allocation; no standards for private duty nursing intensity exist. We sought to characterize provider experiences with and opinions on home nursing for children with HMV, hypothesizing providers would describe frequent home nursing gaps across clinical scenarios. Purposeful and snowball sampling identified key informant clinical providers. Survey topics included hours of home nursing received across clinical and family scenarios. Close-ended responses were analyzed using descriptive statistics and open-ended questions coded with iterative modification for major theme agreement. A total of 59 respondents represented care of patients from 44 states; 49.2% physicians, 37.3% nurses, 10.2% respiratory therapists, and 3.4% case managers. Nearly all (97%) believed that families should receive more hours during initial home transition, yet less than half (47%) do. The majority (80.7%) thought the presence of other children in the home should influence nursing hours, yet only three (5.3%) reported other children have influence. Across hypothetical medical technology scenarios, providers consistently described children receiving fewer nursing hours than the providers’ ideal practice. A third (31.7%) described discharging patients without any home nursing arranged. This HMV provider sample highlights pervasive deficiency in home nursing provision with heterogenous interpretation of what constitutes ideal home care. Family and social contextual factors are infrequently considered in nursing allocations. Provider, community health, and family stakeholders must collaborate to generate national community practice standards for children with HMV.
登录
查看更多内容
影响因子：
3.8
作者：
Kirk, S;Glendinning, C;Callery, P
通讯作者：
Callery, P
影响因子：
1.9
作者：
Israelsson-Skogsberg, Asa;Lindahl, Berit
通讯作者：
Lindahl, Berit
影响因子：
8
作者：
Maynard, Roy;Christensen, Eric;Wheeler, William
通讯作者：
Wheeler, William
影响因子：
1.9
作者：
Maddox, Christina;Pontin, David
通讯作者：
Pontin, David
影响因子：
5.1
作者：
Sobotka, Sarah A.;Foster, Carolyn;Goodman, Denise M.
通讯作者：
Goodman, Denise M.