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目的:调查延续性护理服务模式对综合性医院老年失能出院患者的影响。方法:对出院患者实施预出院评估,筛选出老年失能且带管和(或)伤口未完全愈合的患者,出院后通过责任护士电话回访、居家护理成员上门访视、搭建居家护理宣传平台等实施延续护理干预1年。结果:老年失能患者14天再入院率降低,干预1年后并发症降低。结论:综合性医院实施延续性护理服务模式可减少护理并发症的发生,降低老年失能患者的再入院率。
Objective: To investigate the impact of continuous nursing service on elderly discharged patients in general hospitals. Methods: The discharged patients were evaluated by pre-discharge, and the aged patients who were not able to heal and the wounds and / or wounds were completely healed were screened out. After leaving the hospital, they were interviewed by responsible nurses, visited home nursing members and set up home care publicity platforms Implementation of continuation of nursing intervention for 1 year. Results: The readmission rate of 14-day elderly patients with disability decreased and the complications decreased after 1 year of intervention. Conclusion: The implementation of continuous nursing service in general hospitals can reduce the incidence of nursing complications and reduce the re-admission rate of elderly patients with disability.