醫院整合醫學照護制度與專科護理師的角色

Hospitalist and Nurse Practitioner

10.29494/LN.202006_21(2).0001

卜宜芝(Yi-Chin Bu)；陳強儀(Chiang-Yi Chen)；周曉禎(Hsiao-Chen Chou)；黃俊達(Chun-Ta Huang)

整合醫學照護制度 ； 專科護理師 ； 多重共病 ； hospitalist ； nurse practitioner ； multimorbidity

領導護理

21卷2期（2020 / 06 / 01）

1 - 9

繁體中文

在臺灣慢性病的人口數逐漸增加，合併多重慢性疾病的人口也逐年增多，影響到患者的生活品質與醫療資源的運用。近年來臺灣各大醫院參照美國的醫院整合醫學制度，臺大醫院也成立了「醫院整合醫學制度（Hospitalist）」的病房，運用臨床警示系統（Clinical Alarm System, CAS）與多團隊照護模式（Multiple Disciplinary Team, MDT），協助多重共病患者穩定病情、恢復功能，同時順利銜接長期照護、或末期照護與居家安寧轉銜。醫院整合醫學制度中，除了跨專科的主治醫師外，專科護理師也扮演很重要且多功能的角色，提供患者連續性及整合性的醫療和護理，從直接照顧患者與其家屬、提供醫療和護理指導與臨床教學、並在患者和團隊間協調溝通，在提供一致性的整合照護下，也負責監測醫療護理品質。臨床上，落實推動醫院整合照護以及充分發揮專科護理師的角色和功能，能夠提升醫療照護品質、增加專科護理師之專業與協助患者恢復健康。

As the number of the elder population of chronic diseases gradually increases as well as population with multimorbidity that is influencing the patients' quality of life and medical resources allocation. In recent years, major hospitals in Taiwan have integrated hospitalist medical systems with reference to American hospitals, aiming to provide multidisciplinary care to those patients with multimorbidity. National Taiwan University Hospital has also established Hospitalist Ward, a Multiple Disciplinary Team (MDT) is combined with Clinical Alarm System (CAS) to assist patients with multiple comorbidities to stabilize their condition; from treating acute illness, restoring function, and at the same time, smoothly connect long-term care or managing end-of-life care and possibly referring to home hospice service. In the hospitalist system, apart from interdisciplinary hospitalist, the nurse practitioners also play an important and versatile role. They provide patient with continually integrated medical and nursing care, from delivering direct care to the patients and their families; to provide medical, healthcare instruction, and clinical education; and coordinate communication between patient and the multiple disciplinary team. By monitoring the quality of medical care while providing consistent and integrated care, they are also responsible for monitoring the quality of medical care. Clinically, the implementation of the hospitalist and utilize the role and function of specialist nurses can enhance the quality of medical care, improve the professionalism of specialist nurses and hence assist patients to regain health.

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