Meeting the needs of children with medical complexity using a telehealth advanced practice registered nurse care coordination model.
Meeting the needs of children with medical complexity using a telehealth advanced practice registered nurse care coordination model.
复制标题
使用远程医疗先进的注册护士护理协调模型来满足有医疗复杂性的儿童的需求。
DOI：
10.1007/s10995-014-1654-1
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发表时间：
2015-07
影响因子：
2.3
通讯作者：
Garwick, Ann
中科院分区：
文献类型：
--
作者：
Cady, Rhonda G.;Erickson, Mary;Lunos, Scott;Finkelstein, Stanley M.;Looman, Wendy;Celebreeze, Margaret;Garwick, Ann
关键词：
有效的护理协调是慢性病人群（包括具有医学复杂性（CMC）的儿童）的关键质量和安全策略。然而，在父母报告需要护理协调帮助和接受护理协调帮助方面仍然存在差距。新模式必须缩小这一差距，同时保持以家庭为中心的重点。在一个已建立的医疗之家进行的一项三臂随机对照试验，采用了基于Presler临床护理协调模型的高级实践注册护士干预。该模式支持CMC的家庭，只使用电话或电话和视频远程保健协调。有效性进行了评估，从许多方面，本文报告的一个子集的成果，包括以家庭为中心的护理（FCC），需要护理协调帮助和充分的护理协调帮助收到。基线和研究结束时的FCC显示组间无显著差异。所有组的FCC评分中位数为18.0-20.0，表明医疗之家内的FCC较高。随着时间的推移，小组内部或小组之间对护理协调帮助的需求没有显着差异。在基线时，两组之间接受帮助的充分性没有显着差异。然而，随着时间的推移，这一指标在两个干预组中均显著增加。这些研究结果表明，在一个既定的医疗家庭与高水平的FCC，CMC的家庭有未满足的需求，护理协调的帮助，解决了APRN远程医疗保健协调模式。
Effective care coordination is a key quality and safety strategy for populations with chronic conditions, including children with medical complexity (CMC). However, gaps remain in parent report of the need for care coordination help and receipt of care coordination help. New models must close this gap while maintaining family-centered focus. A three-armed randomized controlled trial conducted in an established medical home utilized an advanced practice registered nurse intervention based on Presler’s model of clinic-based care coordination. The model supported families of CMC across settings using telephone only or telephone and video telehealth care coordination. Effectiveness was evaluated from many perspectives and this paper reports on a subset of outcomes that includes family-centered care (FCC), need for care coordination help and adequacy of care coordination help received. FCC at baseline and end of study showed no significant difference between groups. Median FCC scores of 18.0–20.0 across all groups indicated high FCC within the medical home. No significant differences were found in the need for care coordination help within or between groups and over time. No significant difference was found in the adequacy of help received between groups at baseline. However, this indicator increased significantly over time for both intervention groups. These findings suggest that in an established medical home with high levels of FCC, families of CMC have unmet needs for care coordination help that are addressed by the APRN telehealth care coordination model.
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