Construction Of Hospital-community-family Transitional Care Program For High-risk Infants

PurposeBased on the research on the real experience of different populations in the transitional care of high-risk infants,we explored and constructed a scientific and reasonable high-risk infants’ hospital-community-family transitional care program.The program established a hospital-community-family collaboration mechanism,regulated the behavior of all the staff,optimized the transitional care services for high-risk infants,and provided continuous and effective transitional care services for high-risk infants.Method1.Based on the results of qualitative research,this study analyzed a large number of relevant research literatures,grasped the overall development of the current transitional care services for high-risk infants at home and abroad,exchanged and conducted active discussions and opinions with the panelists.A high-risk infants’hospital-community-family transitional care service program framework was initially constructed.2.After two rounds of Delphi experts’ consultation,the establishment of various dimensions,entries and connotation structure were established,and finally a high-risk infants’ hospital-community-family transitional care program framework map was formed.Using SPSS17.0 software to analyze the collected data and verify the feasibility of experts’consultation content.Result1.On the basis of qualitative research,the first draft of the "High-risk Infants’Hospital-Community-Family Transitional Care Program" was constructed through literature review and theoretical analysis,including a total of 6 dimensions,5 first-level entries,49 secondary-level entries,which was as the first round of the expert consultation questionnaire.2.In the research process,a high-risk infants’ hospital-community-family transitional care program framework was established through two rounds of Delphi experts’consultation.The main contents included the purpose of the program,the implementing organization,the organizational structure and time definition,the job responsibilities and job requirements,the implementation path,and the core service content.It consisted of 6 dimensions,5 first-level entries,56 secondary entries.The weight of each dimension was determined by the superior order graph method.3.Delphi experts’ consultation reliability analysis:30 questionnaires were sent out in the first round of consultation,and 30 questionnaires were recovered,with a recovery rate of 100%,30 valid questionnaires,and the validity rate of 100%,25 experts put forward suggestions,accounting for 73.33%;30 questionnaires were sent out in the second round of consultation,and 30 questionnaires were recovered,with a recovery rate of 100%,30 valid questionnaires,and the validity rate of 100%,3 experts put forward suggestions,accounting for 16.67%.According to this result,it was concluded that the experts had a high degree of recognition for this topic.The authority coefficient of the expert group was 0.863,the personal authority coefficient of the expert group was above 0.725.According to this data,the experts who participated in this questionnaire had certain authority in this field.In the questionnaire consultation process,the general requirement coefficient of variation should be less than 0.25,the smaller the coefficient of variation is,the higher the coordination degree of consultants is.In the study the coefficient of variation of the first round was 0.051～0.264,with an average of 0.127,and the second round was 0.051～0.191,the average value is 0.110.The results were desirable.Therefore,the degree of coordination of the second round of expert opinions was suggested.Experts’ opinions tended to be more consistent.The coordination coefficient W should be between 0 and 1.The greater W is for the same group of consultants and the same group of indicators,the better the degree of coordination is.In the investigation process of this subject,because the content of items in the two consultation rounds became larger,the coordination coefficient of the two consultation rounds was not directly comparable,but basing on the analysis of the two consultation rounds,the coordination coefficient W of the consultation experts’ scores on all items was significant(p<0.01),which indicated that the coordination of expert opinions after the two rounds of consultation was good.ConclusionBased on the results of qualitative research,this study formed the first round of expert consultation questionnaires in conjunction with relevant theories.The high-risk infants’ hospital-community-family transitional care program was revised after two rounds of Delphi experts’ consultation.This study constructed a framework for the participation of hospitals,communities and families in transitional care,taking into account the services provided by hospitals,the services provided by communities,the cooperation of hospitals and communities,the sharing of information among service providers,and participation of high-risk caregivers to transitional care.The aim was to meet the needs of different stages of the transition period for high-risk infants,the core characteristics of the entire nursing process were reflected in the transitional care framework system:continuity of relationship,information and management.1.The transitional care program clarified the purpose,the implementation organization,the organizational structure and time definition,the job responsibilities and job requirements of the medical staff,and established the implementation approach and specific core service content of the transitional care for the high-risk infants.2.The program established information transmission channels through hospitals and communities,builded a network platform,established WeChat groups,hospital nurses trained community nurses and high-risk caregivers,hospital nurses and community nurses conducted families Visiting for high-risk infants,and hospital nurses entered the community by giving lectures and other means to make the transitional care services more practical and enforceable for high-risk infants.3.The program proposed an interactive guide between the hospital and the community,an effective connection between the two services,and emphasized the important role of the community in post-discharge care for high-risk infants.4.Through the program,a personalized discharge plan,neonatal home appropriate technology(courseware+video),neonatal care manual and ahealth education manual had been developed,and "a flow chart for improving the preparedness of high-risk infants to discharge families" and "a flow chart for community transition care after discharge of high-risk infants" had been developed.The program enabled the transitional care service to meet the needs of different stages of high-risk infants.