老年患者出院准备服务专家共识（2019版）

doi:10.3761/j.issn.0254-1769.2020.02.011

摘要/Abstract

摘要：

目的形成老年患者出院准备服务临床实践专家共识,规范老年患者出院准备服务的相关内容。方法运用循证方法,按照证据级别高低,检索、评价和汇总该领域的证据,提取与老年患者出院准备服务相关的推荐建议和研究结论,形成共识初稿,通过2轮专家函询和2次专家论证会,结合专家意见,对初稿进行调整、修改和完善,形成共识终稿。结果 2轮函询专家积极系数均为100%,专家权威程度均为0.83,各指标重要性赋值均数均>3.5,且变异系数均<0.25,专家肯德尔和谐系数分别为0.234和0.253（均P<0.001）。最终对老年患者出院准备服务的概念、主要原则、意义、内容及实施过程5个部分的推荐意见达成一致。结论该共识为老年患者出院准备服务在中国的实施提供了指导依据,促进出院准备服务在中国的实施和发展。

关键词: 出院准备服务, 老年人, 住院患者, 老年护理学, 专家共识

Abstract:

Objective To establish an expert consensus on discharge planning for hospitalized elderly patients. Methods Studies were retrieved,evaluated and collected by the evidence-based nursing method. Revelent recommendations and research results were selected to form the expert consensus draft. Experts were invited to complete 2 rounds of Delphi expert consultation and 2 rounds of expert meeting. Each item was revised and adjusted considering objective evidence and expert opinions. Results The positive coefficients of experts in 2 rounds of Delphi expert consultation were all 100%,and the degrees of expert authority were all 0.83. The average importance value of each item was higher than 3.5;the variation coefficent of each item was less than 0.25;the Kendall’s W were 0.234 and 0.253 respectively（all P<0.001）. At last,experts agreed on 5 dimensions of discharge planning for elderly patients. Conclusion The consensus can not only provide guidance for the clinical practice,but also promote the development of the discharge planning for hospitalized elderly patients in China.

Key words: Discharge Planning, Aged, Inpatients, Geriatric Nursing, Expert Consensus

孙超, 奚桓, 李峥, 栾晓嵘, 王爱平, 赵菁, 邓宝凤, 胡慧秀. 老年患者出院准备服务专家共识（2019版）[J]. 中华护理杂志, 2020, 55(2): 220-227.

SUN Chao, XI Huan, LI Zheng, LUAN Xiaorong, WANG Aiping, ZHAO Jing, DENG Baofeng, HU Huixiu. Expert consensus on the discharge planning for hospitalized elderly patients（version 2019）[J]. Chinese Journal of Nursing, 2020, 55(2): 220-227.

图/表 3

表1 专家函询修改意见

图1 出院准备服务实施流程图注:1）病情是否变化,对于患者出院准备服务需求的评估是一个持续、动态的过程,除了在患者入院24 h内要对患者进行初次筛选评估外,在患者病情发生变化时、患者转入新科室时、患者或家属有新的需求时,都需要对患者重新进行评估。

表2 出院准备服务小组成员及主要职责

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