2018 Fiscal Year Final Research Report

Standardization of nursing for trouble-free treatment and care of patients with dementia at acute exacerbation stage of chronic heart failure

Research Project

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Project/Area Number	15K11577
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Clinical nursing
Research Institution	Hirosaki University
Principal Investigator	Otsu Haruka 弘前大学, 保健学研究科, 准教授 (10382384)
Co-Investigator(Kenkyū-buntansha)	森山美知子広島大学, 医歯薬保健学研究科(保), 教授 (80264977) 高山成子金城大学, 看護学部, 教授 (30163322) 渡辺陽子 (半田陽子) 県立広島大学, 保健福祉学部(三原キャンパス), 講師 (20364119)
Project Period (FY)	2015-04-01 – 2019-03-31
Keywords	慢性心不全 / 急性増悪 / 疾病管理 / 看護援助プロトコル / 認知症
Outline of Final Research Achievements	The purpose of this study is to develop a nursing protocol to prevent treatment interruption by chronic heart failure patients with decreased cognitive function during the acute aggravation phase using a method other than physical restraint. This study was conducted in three steps. As the first step, a draft nursing protocol was created based on previous studies. As the second step, the draft was modified according to the opinions or from the perspective of certified nurses specialized in chronic heart failure and those specialized in dementia to develop a revised version of the nursing protocol. As the third step, usefulness of the revised version of the nursing protocol was assessed to complete the nursing protocol. The nursing protocol was created for 3 phases: immediately after hospital admission, after starting treatments, and recovery. Based on the evaluation results, it was useful for the standardization of nursing care and the prevention of medical accidents.
Free Research Field	認知症看護
Academic Significance and Societal Importance of the Research Achievements	ニーズがありながら、認知機能の低下した患者の心不全治療の中断を予防するための看護プロトコルが、これまでに作成されてこなかった。本研究において作成した看護プロトコルは、以前より臨床現場から求められてきたものであり、意義あるものと考える。また、本看護プロトコルは身体的拘束以外の方法で慢性心不全の急性増悪期の治療を円滑に行うためのものであり、臨床現場においてこれが用いられ、身体的拘束以外の方法による看護ケアの効果が認められれば、身体疾患を有する認知症患者のケアの質向上（認知症ケア加算）にもつながる。また、本看護プロトコルは、医療事故のリスクマネジメントや新人の看護教育としても活用可能であると考える。