関東圏6病院における高齢者看護質評価指標による実践状況と看護実践の卓越性の評価

Evaluation of Nursing Practice Assessed by Quality Indicators of Geriatric Nursing and the Excellence in Nursing Practice among 6 Hospital Settings in Kanto Region

抄録

　本研究では，関東圏6病院における高齢者看護の実践状況と看護実践の卓越性との関連を明らかにすることを目的とした．病棟看護師を対象に，高齢者看護の質指標15領域72項目と看護実践の卓越性自己評価尺度を用いた無記名の質問紙調査を行い，101人より回答を得た．清潔ケア，口腔ケア，身体抑制領域で50％以上がよく行っていると回答していた項目がみられた．一方，包括的アセスメント，認知症ケア，尿失禁，疼痛マネジメント領域では実施割合の低い項目があった．さらに，すべての領域において看護実践の卓越性自己評価尺度との関連を認め，褥瘡予防領域と「医療チームの一員としての複数役割発見と同時進行」，せん妄および身体抑制領域と「患者の人格尊重と尊厳の遵守」において相関がみられた．基本的なケアが行われている一方で，認知症など高齢者特有のケアに対する実施割合が低いことから，今後も高齢者看護の質向上を目指した実践と評価を行っていく必要がある．

　This study examined relationships between geriatric nursing practice and excellence of nursing practice among 6 hospital settings in Kanto region. One hundred and one nurses assessed geriatric nursing practices based on the quality indicators of 15 categories with 72 items on 5-point Likert-type scales. More than 50% of nurses conducted actions in categories such as bed bath, oral care, and physical restraint. On the other hand, part of comprehensive assessment, dementia care, incontinence, and pain management items had low percentages. Moreover, all categories and excellence of nursing practice were correlated, especially between prevention of pressure ulcer and “multiple role finding and simultaneous progress as a team member” and delirium or physical restraint and “respect for patients and observance of dignity.” Although basic care was conducted, provision of specific geriatric care such as dementia was low; therefore, quality improvement and assessment of geriatric practice is needed in the future.