基层医疗卫生机构居家护理服务的安全支持和医务人员服务意愿调查研究  

The Safety Support and Willingness of Providing Home Care Services by Medical Staff of Primary Health Care Institutions

作　　者：高慧 刘素珍[2] 李航 GAO Hui;LIU Suzhen;LI Hang(West China School of Nursing,Sichuan University/Department of Critical Medicine,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Nursing,Sichuan University/West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西护理学院/四川大学华西医院重症医学科,四川省成都市610041 [2]四川大学华西护理学院/四川大学华西医院,四川省成都市610041

出　　处：《中国全科医学》2022年第34期4326-4331,共6页Chinese General Practice

基　　金：四川大学华西护理学科发展专项基金(HXHL19018)。

摘　　要：背景人口老龄化趋势下,罹患多种慢性病的失能或半失能老年人对居家医疗护理服务需求迫切,但基层医务人员提供居家医疗护理服务存在较大的医疗风险和安全隐患,加强居家医疗护理服务的安全管理,有利于提高基层医务人员提供居家医疗护理服务的意愿。目的调查基层医疗卫生机构对居家护理服务的安全支持情况和医务人员的服务意愿,为进一步推动居家医疗护理服务发展提供参考依据。方法2021年8—10月,采用便利抽样法在四川省五大经济区抽取49所基层医疗卫生机构的1131例医务人员。自行设计调查问卷,以“问卷星”电子问卷的形式收集资料。问卷内容包括医务人员的一般情况(8个条目)、提供居家医疗护理服务的经历(2个条目)、医疗机构对医务人员的安全支持(7个条目)、医务人员的居家医疗护理服务意愿(1个条目)。比较不同特征医务人员提供居家医疗护理服务的意愿,采用二元Logistic回归分析医务人员提供居家医疗护理服务意愿的影响因素。结果1131例基层医务人员中,692例(61.18%)报告有过居家医疗护理服务的经历,193例(17.06%)报告在服务过程中发生过不良事件/安全事件,531例(46.95%)报告其所在医疗机构未评估过患者接受居家医疗护理服务的安全风险,199例(17.60%)表示所在机构评估了医务人员提供居家医疗护理服务的安全风险,299例(26.44%)在居家医疗护理服务过程中使用APP定位系统,273例(24.14%)由机构配备报警、延迟预警等设备,807例(71.35%)表示居家医疗护理服务过程中没有获得所在机构内其他医务人员的支持措施,303例(26.79%)表示机构曾组织居家医疗护理服务的专项研讨活动,352例(31.12%)表示接受过有关居家医疗护理服务专项培训,853例(75.42%)表示愿意提供居家医疗护理服务。二元Logistic回归分析结果显示,就职的基层医疗卫生机构类型,目前受聘的Background With the trend of population aging,disabled or semi-disabled elderly people suffering from various chronic diseases have an urgent demand for home medical care services,but there are greater medical risks and safety hazards for primary health care workers to provide home medical care services,and strengthening the safety management of home medical care services is conducive to increasing the willingness of primary health care workers to provide home medical care services.Objective To investigate the safety support of home care services in primary health care institutions and the willingness of medical personnel to provide home care services,so as to provide a reference basis for further promoting the development of home medical care services.Methods From August to October 2021,1131 cases of medical personnel from 49 primary health care institutions in five economic regions of Sichuan Province were selected by convenience sampling method.A self-designed questionnaire was used to collect data in the form of an electronic questionnaire called"Questionnaire Star".The questionnaire included general information of medical staff(8 items),experience of providing medical care at home(2 items),safety support of medical staff by medical institutions(7 items),and willingness of medical staff to provide home care(1 item).The willingness of medical personnel to provide home medical care services was compared across different characteristics,and binary Logistic regression was used to analyze the factors influencing medical personnel's willingness to provide home medical care services.Results Of the 1131 primary care medical personnel,692(61.18%)reported experiences with home medical care services,193(17.06%)reported adverse events or safety events during the services,531(46.95%)reported that their medical institutions had not assessed the safety risks of patients receiving home medical care services,199(17.60%)reported that their institutions had assessed the safety risks of medical staff visiting the home,299(26.44%

关 键 词：居家医疗护理 基层医务人员 职业安全 安全支持 服务意愿 卫生保健措施 社区保健 

分 类 号：R197[医药卫生—卫生事业管理]