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物理治疗师如何降低再次住院率:优化从医院回归社区的老年人的护理结局

  2017-02-04

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【文献标题】Role of Physical Therapists in Reducing Hospital Readmissions:Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community(物理治疗师如何降低再次住院率:优化从医院回归社区的老年人的护理结局)


【文献来源】Physical Therapy August 2016 Volume 96 Number 8 


【文献摘要】老年人群再次住院率是判断医院急诊护理的一项新兴指标。近期证据表明住院时和出院之后的功能减少与再次住院的风险增加有关。然而,现有的为降低再次入院率而发展的护理模式并不足以解决功能损失。物理治疗师作为改善物理状况的专家,有很大的机会对过渡期护理模式做出贡献以及展现物理治疗在降低再次住院率中的价值。因此,此篇前瞻性的文献目的为:1) 描述在老年患者过渡期时物理治疗师参与的需求 和2) 概述在老年患者过渡期时加大物理治疗师参与度的策略,总体目标为减少可避免的30天内再次住院事件。目前,针对降低再次入院率而发展的新型护理模式中没有物理治疗师提供的身体功能状况的相关参数,包括步速、力量或日常生活能力等,而这些都是再住院风险的独立功能预测值。因此,作者呼吁物理治疗师参与制定从住院到出院后接受社区康复的过渡期护理计划,包括提供详细的患者出院总结、与社区物理治疗师顺畅的沟通、帮助确定患者在社区中对于日常协助的需要程度以及监控并管理患者出院后的状况等,帮助降低患者再次住院的概率。


Hospital readmissions in older adult populations are an emerging quality indicator for acute care hospitals. Recent evidence has linked functional decline during and after hospitalization with an elevated risk of hospital readmission. However, models of care that have been developed to reduce hospital readmission rates do not adequately address functional deficits. Physical therapists, as experts in optimizing physical function, have a strong opportunity to contribute meaningfully to care transition models and demonstrate the value of physical therapy interventions in reducing readmissions. Thus, the purposes of this perspective article are: (1) to describe the need for physical therapist input during care transitions for older adults and (2) to outline strategies for expanding physical therapy participation in care transitions for older adults, with an overall goal of reducing avoidable 30-day hospital readmissions.


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