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背景预先护理计划(ACP)可有效改善患者对临终关怀的感受。然而,目前使用ACP的患者还是少数。本研究旨在探究在社区医疗机构中配置ACP协调员是否可增加使用此计划的患者数量。方法 Barwon Health在2008年开始推行ACP项目。训练有素的ACP协调员在社区医疗机构ACP项目室内为患者提供服务。从2012年至今,共有18个社区医疗机构配置了ACP协调员,以便为患者提供及时的现场服务。结果使用ACP的患者由2008—2011年的2 520例增加到2012—2015年的6 847例。2012—2015年,48%使用ACP的患者来自18个配置了ACP协调员的社区医疗机构,这些患者中93%实施ACP完毕;而那些来自未配置ACP协调员的社区医疗机构患者中74%实施ACP完毕,另外那些来自其他机构的患者中仅有55%实施ACP完毕(P<0.01)。结论在社区医疗机构中配置ACP协调员,可以增加使用此计划的患者数量及提高ACP完毕率。
Background The Pre-Nursing Program (ACP) can effectively improve the patient’s feeling of hospice. However, there are still a few patients currently using ACP. The aim of this study was to explore whether deploying ACP coordinators in community health facilities could increase the number of patients using the program. Method Barwon Health started its ACP project in 2008. A well-trained ACP coordinator serves patients within the community health facility ACP project room. Since 2012, a total of 18 community health facilities have deployed ACP coordinators to provide patients with timely on-site services. Results The number of patients using ACP increased from 2,520 in 2008-2011 to 6,847 in 2012-2015. In 2012-2015, 48% of patients using ACP came from 18 community-based healthcare facilities equipped with ACP coordinators, of whom 93% performed ACP; 74% of those with community-based care without ACP coordinators With ACP completed, only 55% of those patients from other institutions completed ACP (P <0.01). Conclusions The deployment of ACP coordinators in community health facilities can increase the number of patients using the program and improve the completion rate of ACP.