住院病人出院準備度臨床評估與護理處置

Clinical Evaluation and Nursing Management of Readiness for Hospital Discharge in Hospitalized Patients

因應全民健康保險導致住院日數縮短，出院準備度評估及出院準備服務可銜接急性醫療照護與亞急性醫療照護，無縫接軌社區照護。本文主要目的為探討住院病人出院準備度定義及重要性、過渡理論於出院準備運用、相關因素、評估工具及護理處置及照護。獨居、高齡、教育程度低、居住地距離醫院較遠、住院天數較短、無醫療保險、家庭收入低及疾病複雜度越高的病人，其出院準備度較差。常見出院準備度評估工具，包括出院準備度量表、照護者出院準備度量表、病人連續性照護量表、出院指導質量量表及出院後問題量表院準備度等評估工具。護理處置包括提供結構化出院計劃、出院轉銜照護、症狀處理因應對策、可利用的社會資源及出院轉介。本文可提供住院病人出院準備度臨床評估與護理處置之參考。

The implementation of national health insurance has contributed to shorter hospital stays. Assessing readiness for hospital discharge and conducting effective discharge planning are crucial in ensuring a smooth transition from acute to sub-acute medical care, ultimately supporting seamless communitybased care. The purpose of this article is to explore the definition and significance of readiness for hospital discharge, relevant transitional care theories and their applications, contributing factors, assessment tools, and nursing management strategies for hospitalized patients. Factors associated with poorer readiness for hospital discharge include living alone, advanced age, low educational level, long distance from home to the hospital, shorter hospital stays, lack of private insurance, low family income, and high disease complexity. Common instruments used to assess discharge readiness include the Readiness for Hospital Discharge Scale (RHDS), the Patient Continuity of Care Questionnaire (PCCQ), the Quality of Discharge Teaching Scale (QDTS), and the Problems After Discharge Questionnaire (PADQ). Nursing management strategies involve structured and transitional discharge planning, symptom management, access to available social resources, and coordination of discharge transitions. This article aims to provide a reference for clinical practice to improve assessment and nursing management of hospital discharge readiness in hospitalized patients.