基于信息化平台网格化居家护理服务模式的构建及应用

Construction and application of gridding home nursing service model based on information platform

目的基于信息化平台网格化管理构建居家护理服务新模式,以期有效解决居家康复群体医疗护理需求。方法2018年11月浙江省台州市成立居家护理服务中心和居家康复护理技能培训中心,建立网格化居家护理服务模式,落实优质护理资源下沉,让社区护士成为居家护理主力军;2019年11月建立居家护理服务信息平台,打造线上、线下一体化居家护理分级管理体系,通过信息共享,分级派单,保障居家护理服务高质、便利、安全。记录2020年1-5月网格化居家护理服务开展情况和患者满意度,评价实施效果。采用χ^(2)检验进行统计分析。结果台州市共28所二级以上医院、123个基层医疗机构、1171名社区护士入驻居家护理信息平台。2020年1-5月护理人员共提供居家护理5274例次,其中上门护理4472例次,线上护理802例次;上门护理患者满意度为98.73%(4415/4472),线上护理患者满意度为98.25%(788/802),两种服务类型满意度比较差异无统计学意义(χ^(2)=1.136,P=0.286)。无投诉、不良事件及护士安全问题发生。结论基于信息化平台的网格化居家护理服务模式可以充分发挥社区护士作用,拓宽居家护理服务范围,合理进行医疗资源配置,为居家康复群体解决医疗护理问题,有效推进分级诊疗。

Objective To construct a new home nursing service model based on information platform grid management,in order to effectively solve the medical care needs of home rehabilitation groups.Methods In November 2018,Taizhou City,Zhejiang Province established the Municipal Home Care Service Center and Home Rehabilitation Nursing Skills Training Center,and established a gridding home nursing service model,and implemented the sinking of high-quality nursing resources,and made community nurses the main force of home care.In November 2019,a home nursing service information platform was established to create an online and offline integrated home nursing grading management system.The high quality,convenience and safety of home nursing services was ensured through information sharing and graded orders.We recorded the development of gridding home nursing services and patient satisfaction from January to May 2020,and evaluated the implementation effects.χ^(2)test was used for statistical analysis.Results Totals of 28 hospitals above ClassⅡ,123 primary medical institutions,and 1171 community nurses in Taizhou have settled on the home nursing information platform.From January to May 2020,nursing staff provided 5274 cases of home care,including 4472 cases of home care and 802 cases of online care.The patient satisfaction of home care was 98.73%(4415/4472),and the patient satisfaction of online care was 98.25%(788/802),there was no significant difference between the satisfaction of two service types(χ^(2)=1.136,P=0.286).No complaints,adverse events and nurse safety issues occurred.Conclusions The gridding home nursing service model based on information platform can give full play to the role of community nurses,broaden the scope of home care services,rationally allocate medical resources,solve medical care problems for home rehabilitation groups,and effectively promote hierarchical diagnosis and treatment.