Components of nursing judgment on quality improvement of home health care in one unit of the community

摘要本研究旨在探讨社区某单位家庭健康照护品质改善之护理判断成分。本研究考察了大单位面积和小单位面积的护理累积和合作活动。进行了以下五项调查：调查一；在某县卫生院辖区内做了活动累计的护理判断。采用访谈法和资料法对公共卫生护士30年累计活动的判断进行检验。从患者及家属的需求、措施的选择、评价、新需求的获取、方向等方面发现了反复判断的过程。结果表明，与评价相关的护理判断对提高家庭保健质量具有重要意义。调查2；县卫生院辖区居家照护质量及护理评价：对残障儿童居家照护体系建设情况进行分析，并对护理人员进行参与观察和访谈。研究发现，与支持护理环境相关的护理判断，以及对家庭独立托儿服务的日常护理和特殊护理的满意度是提高家庭保健服务质量的关键。调查3；市区居家护理质量与护理判断：C市17个区b类功能培训活动分析对这些活动的参与情况进行了观察，并对phn进行了访谈。结果表明，护理判断的可及性、日常生活的连续性、心理的宽慰与舒适、患者与住院医师的平等关系以及对自身社区的形成兴趣等方面对提高家庭保健质量至关重要。调查4；家庭健康护理中的合作活动与护理判断：近5年国内文献分析。通过对51篇文献的分析，发现合作活动是充实和提高医疗和日常生活各支持体系质量的有效途径。调查五：社区卫生护理实习回顾：关注公共卫生护士在提高居家护理服务质量中的作用这是本研究的初步调查，旨在探讨涵盖护理基本概念的护理判断。分析护理本科学生在家护理服务质量提高的实习经验。少

The purpose of this study was to identify the components of nursing judgement on quality improvement of home health care in one unit of the community. This study examined nursing accumulative and cooperative activities in both wide and small unit area. Five investigations were conducted as follow :Investigation 1; The nursing judgement with accumulative activities having done in one prefectural health center territory.The judgment of public health nurses' accumulative activities in 30 years were examined by interview and material. The repeated judgment process was found in relation with the needs of patients and their families, the measure selected, the evaluation, the getting new needs and the direction. It was suggested the nursing judgment related with the evaluation was important to quality improvement of home health care.Investigation 2 ; The quality of the home care in the prefectural health center territory and the nursing judgement : The analysis of the constructing home care s … More ystem activity for disabled childrenThe participation observation and the interview to PHNs were conducted. It was found that the nursing judgment related with the support care environment and the satisfying both of the daily and special care against the independent child care for families were essential to quality improvement of home health care.Investigation 3 ; The quality of the home care in the municipal area and the nursing judgement : The analysis of the B-type functional training activities in 17 area, C city.The participation observation and the interview to PHNs related to those activities were conducted. It was found that the nursing judgment related with the accessibility, continuity to daily life, relief and comfortable mind, equal relationship between patients and residents and formation interest to the own community were essential to the quality improvement of home health care.Investigation 4 ; The cooperative activities and the nursing judgement in home health care : Analysis of the domestic literature in past 5 yearsWith the examination of 51 literature, the cooperative activities were effective way with filling and improving both of quality of the medical and daily living each support and system.Investigation 5 : A review of community health nursing practicum: Focusing the roles of public health nurse on quality improvement of home care serviceThis review was done as the preliminary investigation of this study to explore the nursing judgment which covers the basic concept of nursing. Practicum experiences which concerned quality improvement of home care service of the nurse bachelor's degree course students were analyzed. Less