Analysis of the Relationship between Nursing Professional Judgment and Home Health Care Quality

本研究旨在从质与量的观点，探讨护理人员专业判断与居家照护品质的关系。在英国的初级保健中，地区护士有很大的专业判断力。英国政府期望哪种技能组合不仅能提高成本效益，而且能改善每个病人的生活质量和健康控制，我们于1999年和2000年访问了英国，并通过访谈纠正了有关家庭保健最近变化的信息。通过对资料的分析，对日本护士门诊的情况进行了调查。从567个访问护士办公室收集的1007个病例资料中，分析了日本整体的护理专业判断状况及其影响因素，认为家庭医生应给予访问护士一定程度的专业判断权限。但我们可以理解，这些护士在这些情况下有高质量的技能。预期结果是快速提供服务和减少医疗资源的使用。

The purpose of this study is identified relationship between nursing professional judgment and home health care quality from quantitative and qualitative viewpoint. In UK primary care, district nurses are having extent power of professional judgment. The UK government has expectation of which skill mix contribute to not cost-effectiveness but improvement of QOL and health control of each client.We visited UK and correct the information about recently change of home health care by interview in 1999 and 2000. After analysis of the information, we surveyed about situation of visiting nurse office in Japan. We could get 1007 case data from 567 visiting nurse offices concerning to the situation of the nursing professional judgment and influential factors as whole Japan data.It was suggested that home physicians gave visiting nurses some permissions of professional judgment in relation to medical view and action. But we could understand that those nurses had high quality skill in those cases. It was expected that the outcome was speedy service providing and decreasing of medical resource use.