Process evaluation of a trial evaluating a multidisciplinary nurse-led home visiting programme for vulnerable older people

Purpose.?This article describes the content of and adherence with a nurse-led home visiting programme (Dutch Geriatric Intervention Programme; DGIP) for vulnerable older people. The randomised Dutch EASYcare Study showed positive patient endpoints for DGIP. Describing content and adherence is rarely performed, but highly important for understanding the results of trials.

Method.?DGIP is a complex multicomponent intervention tailored to the patients' needs. This process evaluation describes these components and patient characteristics and creates meaningful clusters of these specific components using hierarchical cluster analysis. Both patient/caregiver and physician adherence rates and possible predictors were investigated.

Results.?In line with the heterogeneity among the subjects, the individual treatment plans turned out to be highly tailored. Cluster analysis identified five clusters of intervention components. DGIP turned out to be largely unsuitable for one group of very vulnerable older participants in urgent need of more care. Overall, physician adherence was 75% and was better than patient adherence (51% complete/partial adherence). Adherence levels increased when both patients, caregivers and physicians received recommendations.

Conclusions.?The content of a multicomponent tailored home-visiting programme was very diverse, matching the heterogeneity among frail elderly subjects. Detailed process and cluster analysis helped to understand the content of the intervention, sharpen target criteria and identify possibilities to improve adherence.     

某院47名护士长高危药物外渗相关态度技能认知调查分析

目的了解护士长对高危药物外渗态度技能知识掌握情况,为加强高危药物的风险管理提供依据,促进护理持续质量改进.方法采用自制高危药物外渗相关态度技能知识调查问卷对暨南大学附属第一医院47名护士长进行调查评定,调查内容包括高危药物外渗相关态度、技能和知识3个维度,采用SPSS 16.0统计软件进行系统描述分析.结果关于高危药物外渗态度、技能、知识的平均正确率分别为99%、75%、23%;加权后总体平均正确率为70%.不同年龄、学历、职称、工作年限的护士长问卷总体平均正确率差异均无统计学意义(P>0.05).结论护士长在高危药物外渗态度方面掌握较好,在技能和知识方面存在欠缺.作为风险管理者和质量控制者,护士长应同时重视处理高危药物外渗技能和知识方面的提高.     

新护士带教方法的再探讨

目的探讨一种在新护士带教中既节省时间又全面系统的带教方法。方法便利抽样法选择2008年5月至2011年lO月在保定市第二中心医院妇产科轮转的新护士60名为研究对象。按随机数字表法将其分为观察组和对照组,每组30名。观察组新护士接受多个老师的带教,对照组新护士按一对一带教。带教3个月后,两组新护士进行综合考评并比较带教效果。结果观察组新护士在操作技术、疾病宣教、护理查房、表格书写、口头提问等方面均优于对照组,差异均有统计学意义（均P〈O．05）。结论多个老师的带教较一对一带教能使新护士在更短时间内全面、系统地掌握护理知识及治疗方法。