Can a Nursing Home Psychotropic Reduction Project be Successfully Implemented in Assisted Living?
Can a Nursing Home Psychotropic Reduction Project be Successfully Implemented in Assisted Living?
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DOI：
10.1177/0733464820948328
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发表时间：
2020-08-08
影响因子：
3
通讯作者：
Mueller, Christine
中科院分区：
文献类型：
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作者：
Abrahamson, Kathleen;Davila, Heather;Mueller, Christine
本研究的目的是比较两种类型的住院长期护理机构（疗养院（NH）和辅助生活（AL）机构）精神药物减少项目的实施情况。来自同一连锁企业的 15 家 NH 和 14 家 AL 机构参与了精神药物减少项目。我们采用比较案例研究的方法，对来自参与项目的 NH 和 AL 设施的 62 名工作人员进行了面对面和电话采访，以调查项目实施的经验。更加制度化的 NH 模式下的项目实施给居民的生活和药物使用带来了巨大的变化。相反，AL 环境中发生的变化似乎对住院医师的药物使用和以住院医师为中心的叙述的影响较小，并且 AL 工作人员发现了许多实施障碍。在不增加 AL 设施监管负担的情况下确定监测护理过程和结果的方法可能会提高质量改进工作在不同环境中的可转移性。
The objective of this study was to compare implementation of a psychotropic medication reduction project across two types of residential long-term care settings: nursing homes (NH) and assisted living (AL) facilities. Fifteen NHs and 14 AL facilities from within a single corporate chain participated in the psychotropic medication reduction project. Using a comparative case study approach, we conducted in-person and telephone interviews with 62 staff members from participating NH and AL facilities to investigate the experience of project implementation. Project implementation within the more institutional NH model produced dramatic changes in residents' lives and medication use. Conversely, changes made in the AL environment appeared to have less impact on resident medication use and resident-centric narratives, and AL staff identified numerous barriers to implementation. Identifying methods to monitor processes and outcomes of care without increasing the regulatory burden of AL facilities may increase transferability of quality improvement efforts across settings.