Summarizing social support is a multifaceted concept which is not explained by a single concise definition. The main attributes of all definitions of social support is the provider, the recipient, the support and the environment in which all these attributes occur and interact. Although the concept of social support is not always accurate as to how is defined and measured, however, addressing these limitations is an important step in designing effective intervention rehabilitation programs.
The assessment of needs for hospitalized patients should be an integral part of the treatment process and part of the training program for the nurses. In addition, this process should start very early, from the diagnosis stage until the discharge from hospital. Author Guidelines Submit Manuscript. Visit for more related articles at Health Science Journal. Need for self-care Participation and self-care is defined as the extent to which the patient is involved in the treatment and in decisions concerning it.
References Stevens A. Needs assessment: from theory to practice. James M. Towards an integrated needs and outcome framework. Health Policy. Robinson J. Health needs assessment, theory and practice. New York, Churchill Livingstone, Davidson PM. Contemp Nurse. Davidson JE. Gap analysis of cultural and religious needs of hospitalized patients. Crit Care Nurs Q. Seddon ME. Systematic review of studies of quality of clinical care in general practice in the UK, Australia and New Zealand.
Qual Health Care. Sofaer S. What do consumers want to know about the quality of care in hospitals? Health Serv Res. Asadi-Lari M. Need for redefining needs.
Health Qual Life Outcomes. Unmet health needs in patients with coronary heart disease: implications and potential for improvement in caring services. Health Quality Life Outcomes. Ridd M. The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives. Br J Gen Pract. Beck RS. J Am Board Fam Pract. Unger J-P. Doctor-patient communication in developing countries. BMJ ; Lings P. The doctor-patient relationship in US primary care. J R Soc Med.
Teutsch C. Patient-doctor communication. Med Clin North Am. Scott JT. Assessing the information needs of post-myocardial infarction patients: a systematic review. Patient Educ Couns. Timmins F. A review of the information needs of patients with acute coronary syndromes. Nurs Crit Care. Clark JC. Heart failure patient learning needs after hospital discharge.
Appl Nurs Res. Czar ML. Perceived learning needs of patients with coronary artery disease using a questionnaire assessment tool. Heart Lung. Ojanlatva A. This updated and expanded collection of orders can help you admit patients more efficiently and effectively. Fam Pract Manag. One year prior to this, we had started a hospital service consisting of one of our senior staff physicians working with a second-year resident from the local family medicine residency.
Eventually, all of our physicians began to share this responsibility one week at a time, which left each of our doctors having a fairly intensive inpatient experience every three to four months. Because of the wide scope of family medicine, we cared for patients with a wide variety of medical conditions.
Our reasons for developing the standardized admission orders were threefold. Like many physicians, we were sometimes basing our care on what we learned in training or from colleagues, rather than on current evidence.
Second, we felt that by reducing variability, the orders could also help contain costs. Our practice is approximately 70 percent to 75 percent capitated, so cost reduction is a significant issue for us.
As we created the admission orders, we reviewed them with local specialists in the relevant fields and also with our primary hospital to help establish the most cost-effective therapies for our particular hospital practice. For example, in the treatment of UGI bleeding, many of our physicians were using IV H 2 -blockers for initial management, although oral medications were as effective yet less costly in patients not actively vomiting. Our third reason for developing the orders was simply a matter of physician convenience and efficiency.
Once we decided which conditions we wanted to develop standard orders for, we assigned just one or two to each of our physicians to research and compose. We encouraged the physicians to take an evidence-based approach, and we sought input from appropriate specialists. The orders were then formatted using a standard template to ensure that routine issues such as diet, activity, prn medications, etc. The hospital information system staff then assisted us in making the forms easily accessible from any of the computer workstations throughout the hospital.
We can also access the forms at our clinic and at our urgent care department, where many of our admissions originate. In addition, we are now working to format the orders for use on hand-held computers. Our experience using the standard admission orders over the past two years has been very positive. We believe the orders have in fact helped us with cost, quality and convenience. Paying for Care After Discharge You might not be aware that insurance, including Medicare, does not pay for all services after a patient has been discharged from the hospital.
Improving the System As we have mentioned throughout this Fact Sheet, discharge planning is an inconsistent process that varies from hospital to hospital. Broader recommended changes in practice and policy include: Formally recognize the role families and other unpaid caregivers play, include them as part of the healthcare team, and assess their capabilities and willingness to provide care.
Coordinate care across sites, from hospital to facility to home. Improve communication between hospital and community-based services.
Develop better educational materials, available in multiple languages, to help patients and caregivers navigate care systems and understand the types of assistance that might be available to them, both during and after a hospital stay. Improve training for healthcare staff, including ways to respond to language, culture, and literacy differences.
Simplify and expand eligibility for public programs. Make transitional care a Medicare benefit; change reimbursement policies to cover more home-based care in addition to institutional care.
Reward hospitals and physicians that improve patient well-being and reduce readmissions to hospitals. Conclusion Multiple studies have explored the importance of effective discharge planning and transitional care, and have highlighted the very real benefits in improved patient outcomes and lower rehospitalization rates. What should I watch out for? Will we get home care and will a nurse or therapist come to our home to work with my relative?
Who pays for this service? How do I get advice about care, danger signs, a phone number for someone to talk to, and follow-up medical appointments? Have I been given information either verbally or in writing that I understand and can refer to? What kind of care is needed? Bathing Dressing Eating are there diet restrictions, e. Certain foods not allowed? Personal hygiene Grooming Toileting Transfer moving from bed to chair Mobility includes walking Medications Managing symptoms e. Are there stairs?
Will we need a ramp, handrails, grab bars? Are hazards such as area rugs and electric cords out of the way? Will we need equipment such as hospital bed, shower chair, commode, oxygen tank? Where do I get this equipment? Who pays for these items? Will we need supplies such as adult diapers, disposable gloves, skin care items? Where do I get these items? Do I need to hire additional help? Questions about training: Are there special care techniques I need to learn for such things as changing dressings, helping someone swallow a pill, giving injections, using special equipment?
Have I been trained in transfer skills and preventing falls? Who will train me? When will they train me? Can I begin the training in the hospital?
Questions when discharge is to a rehab facility or nursing home: How long is my relative expected to remain in the facility? Who will select the facility? Have I checked online resources such as www.
Is the facility clean, well kept, quiet, a comfortable temperature? Does the staff speak our language? Is the food culturally appropriate? Is the building safe smoke detectors, sprinkler system, marked exits? Is the location convenient? Do I have transportation to get there? For longer stays: How many staff are on duty at any given time?
What is the staff turnover rate? Is there a social worker? Do residents have safe access to the outdoors? Are there means for families to interact with staff? Is the staff welcoming to families? Questions about medications: Why is this medicine prescribed? How does it work? How long the will the medicine have to be taken?
0コメント