长期照护机构中的新型冠状病毒疫情:教训与启示  

COVID-19 pandemic in long-term care:An international perspective for policy considerations

作　　者：Doris Grinspun Jennifer H.Matthews Robert Bonner Teresa Moreno-Casbas Josephine Mo 

机构地区：[1]Expert Panel on Building Health Care Systems Excellence,American Academy of Nursing,Washington,DC,USA [2]Registered Nurses’Association of Ontario,Toronto,Ontario,Canada [3]School of Nursing,Shenandoah University,Winchester,VA,USA [4]Australian Nursing&Midwifery Federation(SA Branch),Ridleyton,SA,Australia [5]Expert Panel on Global Health,American Academy of Nursing,Washington,DC,USA [6]Unidad de Investigacion en Cuidados de Salud(Investen-isciii)del Instituto de Salud Carlos III,Madrid,Spain [7]Centro de Investigacion Biomedica en Red en Fragilidad y Envejecimiento Saludable(CIBERFES),Madrid,Spain

出　　处：《International Journal of Nursing Sciences》2023年第2期158-166,共9页国际护理科学（英文）

摘　　要：探讨4个高收入国家长期照护机构在新型冠状病毒疫情期间系统性失误的关键因素,并试图提出实践和政策方面的解决方案,以避免不幸状况再次发生.基于澳大利亚、加拿大、西班牙和美国报告的数据,分别从宏观、中观和微观层面对实践和政策的干预提出建议.宏观层面的建议主要包括提高经费和透明度、问责制和卫生系统一体化,以及促进发展非营利和政府运营的长期护理机构.中观层面的建议涉及从长期照护从"仓库式"管理转向更加舒适的"绿色家园(green houses)".微观层面的建议强调应规定执业人员配备水平和技能组合,提供感染预防和控制方面的培训,为长期照护机构的入住者和工作人员提供福利和心理健康支持,建立循证实践文化,保障工作人员和护理专业学生的持续教育,以及充分整合照顾伙伴,比如,让家人或朋友融入到医疗照护团队中.这些建议的制订将有助于改善长期照护机构入住者的安全和生活质量,让家人安心,以及留住工作人员和提高其工作满意度.This paper identifies key factors rooted in the systemic failings of the long-term care sector amongst four high income countries during the COVID-19 pandemic.The goal is to offer practice and policy solutions to prevent future tragedies.Based on data from Australia,Canada,Spain and the United States,the findings support evidence-based recommendations at macro,meso and micro levels of practice and policy intervention.Key macro recommendations include improving funding,transparency,accountability and health system integration;and promoting not-for-profit and government-run long-term care facilities.The meso recommendation involves moving from warehouses to“green houses.”The micro recom-mendations emphasize mandating recommended staffing levels and skill mix;providing infection pre-vention and control training;establishing well-being and mental health supports for residents and staff;building evidence-based practice cultures;ensuring ongoing education for staff and nursing students;and fully integrating care partners,such as families or friends,into the healthcare team.Enacting these recommendations will improve residents’safety and quality of life,families’peace of mind,and staff retention and work satisfaction.

关 键 词：老年人 新型冠状病毒疾病 医疗卫生变革 老年人健康服务 老人院 长期护理 疗养院 疾病大流行 

分 类 号：R47[医药卫生—护理学]