Nurse-physician communication and quality of drug use in Swedish nursing homes
Nurse-physician communication and quality of drug use in Swedish nursing homes
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DOI：
10.1016/s0277-9536(01)00146-0
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发表时间：
2002-06-01
影响因子：
5.4
通讯作者：
Svarstad, BL
中科院分区：
文献类型：
--
作者：
Schmidt, IK;Svarstad, BL
本研究的目的是探讨瑞典疗养院的精神药物使用的质量，同时控制居民的组合和其他养老院的特点，护士与医生的沟通质量的影响。数据收集从36个瑞典养老院提供护理的1645名居民的样本。药物使用数据，沿着居民的人口统计学特征，从居民的药物管理列表中获得，病房护士报告其他居民的特征（例如，诊断和行为问题的频率）。从护士长处获得设施特征。药物使用的质量进行了评估和研究变量之间的横截面关系进行了比较。结果的措施包括两个药物使用质量分数反映药物和多药的选择。为了评估行为问题，通过一些步骤创建了一个最常见的问题列表，包括目标人群中的焦点小组。此外，一个有效的和可靠的量表评估通信质量的发展。这项措施被纳入对36个设施的护士进行的调查。有一个显着的变化，在药物使用的质量根据两种药物的措施。正如所预测的那样，药物使用的质量与护士-医生沟通的质量呈正相关，与定期的多学科团队讨论药物治疗有关，与居民行为障碍的患病率呈负相关。设施规模，人员配备水平，居民的诊断组合，和人口结构的两个药物质量的措施无关。未来提高长期机构药物使用质量的努力应考虑改善医疗保健专业人员之间的沟通技巧和沟通习惯的方法。(C)2002爱思唯尔科技有限公司版权所有。
The objective was to explore the impact of the quality of nurse-physician communication on the quality of psychotropic drug use in Swedish nursing homes, while controlling for resident mix and other nursing home characteristics. Data were collected from a sample of 36 Swedish nursing homes providing care for 1645 residents. Drug use data, along with residents' demographic characteristics, were obtained from residents' medication administration lists, Ward nurses reported other residents' characteristics (e.g. diagnosis and frequency of behavioral problems). and facility characteristics were obtained from head nurses. The quality of drug use was assessed and cross-sectional relationships among study variables were compared. Outcome measures included two drug use quality scores reflecting selection of drug and polymedicine. To assess behavioral problems, a list of the most commonly observed problems was created through a number of steps, including focus groups in the target population. Furthermore, a valid and reliable scale for assessing communication quality was developed. This measure was included in a survey administrated to nurses in the 36 facilities. There was a remarkable variation in the quality of drug use according to the two drug measures. As predicted, the quality of drug use was positively associated with the quality of nurse-physician communication and with regular multidisciplinary team discussions addressing drug therapy and negatively associated with prevalence of behavioral disturbances among residents. Facility size, level of staffing, resident's diagnostic mix, and demographic mix were unrelated to the two drug quality measures. Future efforts to improve the quality of drug use in long term facilities should consider ways of improving communication skills and communication routines among health care professionals. (C) 2002 Elsevier Science Ltd. All rights reserved.