Vodenje evidence o astmi v referenčni ambulanti

magistrsko delo Management v zdravstvu in socialnem varstvu

Barbara Lackovič (Author), Zvone Balantič (Mentor), Saša Kadivec (Co-mentor)

Abstract

Astma, kot najpogostejša kronična pljučna bolezen, zahteva kakovostno zdravstveno obravnavo bolnikov že na primarnem nivoju. Kronični bolnik je največkrat v stiku z izbranim osebnim zdravnikom, saj prihaja po redno terapijo, v primeru poslabšanja kronične bolezni in v primeru nove akutne bolezni. Na redne letne kontrole pri specialistu bolniki pogosto pozabijo ali pa le-te odlagajo, saj jih odvračajo dolge čakalne dobe, ki kljub naročanju nastajajo v čakalnicah specialističnih ambulant. Pomemben korak na poti k napredku in razvoj primarnega zdravstvenega varstva na slovenskih tleh je Ministrstvo za zdravje začrtalo v aprilu 2011 z uvedbo referenčnih ambulant. V ambulante družinske medicine se uvede nov član, diplomirana medicinska sestra, ki, kot strokovnjakinja na svojem področju, z znanjem in izkušnjami prevzema točno določene naloge in odgovornosti, ki so zapisane v protokolih obravnave posamezne kronične bolezni. Poleg razbremenitve izbranega osebnega zdravnika naj bi prispevala velik delež k boljši kakovosti življenja bolnikov s kronično boleznijo in razbremenitvi specialističnih ambulant. Diplomirana medicinska sestra skrbno vodi registre bolnikov s kronično boleznijo, skrbi za njihovo zdravstveno obravnavo po strokovnih protokolih in najnovejših kliničnih smernicah ter hkrati skrbi za nenehno poučevanje bolnikov. Dobro poučen bolnik s kronično boleznijo in redno obravnavo pri diplomirani medicinski sestri v referenčni ambulanti se lahko izogne poslabšanjem in pogostim obiskom v ambulanti izbranega osebnega zdravnika. V magistrskem delu je analiziran potek zdravstvene obravnave kroničnih bolnikov z astmo v referenčni ambulanti in opravljena je primerjava z obravnavo kroničnih bolnikov z astmo v primerjalni ambulanti, ki v procesu obravnave še ne sledi smernicam referenčne ambulante. Raziskavo smo opravili v Zdravstveni postaji Senovo, sodelovalo je 76 kroničnih bolnikov z astmo. Raziskava temelji na dveh predpostavljenih hipotezah. S prvo hipotezo smo raziskali statistično pomembno boljše kazalnike zdravstvene obravnave pri bolnikih, vodenih v referenčni ambulanti, v drugi hipotezi pa smo raziskali, ali imajo bolniki, vodeni v referenčni ambulanti, statistično pomembno več znanja o svoji bolezni, o pomenu rednega jemanja zdravil in pravilni tehniki jemanja zdravil v primerjavi z bolniki, ki se vodijo v primerjalni ambulanti. Kljub temu, da hipotez, ki smo si jih v raziskavi zastavili, nismo v celoti potrdili, smo prišli do zaključka, da je uvedba referenčnih ambulant prava pot k razvoju primarnega zdravstvenega nivoja, saj so rezultati vseeno pokazali, da je že po prvem letu delovanja diplomirane medicinske sestre v timu splošne ambulante opazna razlika.

Keywords

astma;kronična bolezen;referenčna ambulanta;

Data

Language:	Slovenian
Year of publishing:	2013
Typology:	2.09 - Master's Thesis
Organization:	UM FOV - Faculty of Organizational Sciences
Publisher:	[B. Lackovič]
UDC:	614.2
COBISS:	7255827
Views:	2036
Downloads:	362
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	KEEPING THE ASTHMA RECORDS IN THE REFERENCE CLINIC
Secondary abstract:	Asthma as the most common chronic lung disease requires quality medical treatment for patient at the primary level. Chronically patient is often in contact with general practitioner when they are coming for regular prescriptions, in the cases of aggravation of chronic diseases and in the appearance of new acute illness. Patients often forget to go to regular annually control to specialist of pulmology on the secondary level or they dispose of it because of long waiting time in spite of orders generated at the specialists clinics. An important step on the road to progress and development of primary health care on Slovenian territory, the Ministry of health have done in April 2011 with the introduction of reference clinics. In ambulance of family practitioner was introduced a new member, a register nurse who, as a specialist in its field, with expertise and knowledge, is taking over some defined tasks and responsibilities, which are noted in the protocol of treatment of specific chronic diseases. In addition to relieving of selected general practitioner is expected high share of better quality of life for patient with chronic disease and relieving of specialist' clinic. Register nurse carefully kept records of patient with chronic disease, taking care for their medical treatment under the protocols and the latest clinical guidelines whilst ensuring the constant health education of patients. Well-informed patient with chronically disease and regular annual visits at nurse in reference ambulance can avoid deterioration and frequent visits of the ambulance of selected family doctor. In our work we analyse some treatment of chronically ill patients in reference ambulance and after we compare treatment of chronically ill patients in the comparator ambulance which in the treatment process does not follow the guidelines of reference ambulance. The research was conducted in the Medical station Senovo, involving 76 patients with chronic asthma. The study is based on two predicted hypotheses. With the first hypothesis we studied statistically significantly important indicators of medical treatment in patient managed in a reference ambulance. In the second hypothesis, we investigated whether patients, guided by the reference ambulance, have significantly more knowledge about their disease, the importance of regular taking of medication and proper technique of taking of medication compared with patients who are kept in comparative ambulance. Although the hypotheses, we have investigated, we are not fully confirmed, we came to the conclusion, that the introduction of reference ambulances is the way to the development of primary health care. Results have shown that already after the first year of working of register nurse in the team of family practitioner in noticeable difference.
Secondary keywords:	asthma;chronic disease;reference clinic;education;indicator of the quality;
URN:	URN:SI:UM:
Type (COBISS):	Master's thesis/paper
Thesis comment:	Univ. v Mariboru, Fak. za organizacijske vede
Pages:	79 f.
ID:	8728392