安宁疗护门诊的构建与应用效果

目的 建立安宁疗护门诊,满足更多终末期患者的需求。 方法 设置安宁疗护诊室,由护士出诊,对患者进行筛查、签订安宁疗护知情同意和意愿确认书、全面评估、建立档案、发起多学科会诊、制订照护方案、合理转介、定期随访、提供安宁疗护信息咨询。统计门诊工作量和成效。 结果 2020年10月安宁疗护门诊开诊,至2021年5月30日,门诊量为136例次,针对患者痛苦症状,出诊护士能独立解决108项,发起多学科会诊28次;开展“互联网+”居家照护59例次、收治入院52例、转介基层医院25例;随访388例次。患者的安宁疗护需求满足程度较高;患者综合服务满意度为99.5%,家属综合服务满意度为99.3%。 结论 安宁疗护门诊能够满足终末期患者的需求,体现公立医院的公益性,整合地区资源进行区域安宁疗护联动,促进安宁疗护分级诊疗的开展,加强安宁疗护专科护士培养,推动安宁疗护事业的进一步发展。

Establishment and application of palliative care outpatient

Objective In order to meet the palliative care needs of more end-stage patients,our hospital established a palliative nursing outpatient. Methods Specialized nurses provide consultations,screening,comprehensive evaluation,initiation of multidisciplinary consultations,shared decision-making between doctors and patients,signing of consent forms for informed and willingness confirmation,care plans,referrals and regular follow-ups. Results From October 2020 to 30 May 2021,136 patients were served. Specialist nurses were able to solve 108 items independently and initiated 28 times of multidisciplinary consultations. 52 patients were admitted to the hospital for inpatient care;59 patients received home care and 25 patients were referred to primary hospitals. There were 388 follow-ups. The comprehensive satisfaction of the clinical service was relatively high with 99.5% by patients and 99.3% by patient’s families. Conclusion Palliative nursing clinic led by specialist nurses can meet the people’s needs for palliative care,reflect the public welfare of hospitals,integrate regional resources,strengthen the training of specialist nurses for palliative care,promote the development of graded medical care for palliative care as well as the progress of social civilization.