Проект рак молочной железы

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Документы

Содержание 18. Роль волонтерских организаций Пациентки должны быть информированы о наличии волонтерских служб по оказанию помощи больным раком молочной железы, и о том, каку 18.1 Волонтеры и группы поддержки Пациенткам, их родственникам и друзьям должна быть предоставлена информация о ближайших к ним группах поддержки больных раком мо Группы, которые рекомендует персонал больницы, должны иметь в своем составе медицинских работников. 19. Внедрение рекомендаций 19.2 Клинический аудит и создание базы данных Комментарии рабочей группы. 19.3 Индикаторы исходов 19.4 Памятки для пациентов 19.5 Непрерывное профессиональное развитие 19.6 Информация для пациентов Список литературы

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Рабочая нагрузка

Большинство медсестер не пользуются системой охраны труда138, 209, 210, что ведет к опасности постоянного стресса, изоляции и «горящих» ситуаций на рабочем месте211. В одном из исследований предлагается «разумная» рабочая нагрузка для медсестер – 150 вновь диагностированных пациенток в год, хотя большинство из 108 опрошенных медсестер имели нагрузку 190 новых пациенток за год¹³⁸.

(Уровень III).

. Медицинские сестры по уходу при раке молочной железы должны пользоваться определенной системой охраны труда и иметь годовую норму по обслуживанию пациентов (в настоящее время рекомендуется ≤ 150 пациентов в год).


18. Роль волонтерских организаций


Многие пациентки обращаются за помощью и информацией в волонтерские организации, либо в дополнение к получаемому медицинскому обслуживанию, либо отдавая им предпочтение²¹².

Пациентки должны быть информированы о наличии волонтерских служб по оказанию помощи больным раком молочной железы, и о том, какую информацию они предоставляют.


18.1 Волонтеры и группы поддержки

В тех случаях, когда медработники пользуются услугами волонтеров, важно, чтобы последние имели соответствующую подготовку и были способны оказать помощь, которая от них ожидается. Группы поддержки могут оказать важное содействие в эмоциональном восстановлении пациенток с раком молочной железы^213-215.

Пациенткам, их родственникам и друзьям должна быть предоставлена информация о ближайших к ним группах поддержки больных раком молочной железы.

Группы, которые рекомендует персонал больницы, должны иметь в своем составе медицинских работников.


Комментарии рабочей группы.

Рабочая группа обращает внимание пациенток с заболеваниями молочной железы, что более благоприятной будет помощь волонтерских организаций, которые сотрудничают со специализированными онкологическими и маммологическими учреждениями государствнной системы здравоохранения.


19. Внедрение рекомендаций


19.1 Создание локальных рекомендаций

Планируется, что эти материалы будут окончательно утверждены после обсуждения их на местах с привлечение медицинского персонала и администрации. Комитет по клиническому аудиту в регионах будет задействован в полной мере. Вслед за этим, на местах могут быть разработаны собственные нормативно-справочные материалы, позволяющие применить общенациональные требования в работе конкретной больницы, подразделения или в частной практике.

Это может быть сделано с помощью разнообразных средств, включая ориентированные на потребности пациентов инструкции, непрерывное обучение и тренинги, клинический аудит.


19.2 Клинический аудит и создание базы данных

Ретроспективные проверки в государственном масштабе были ранее предприняты SCTN⁴², и это стало хорошей основой для проверок по использованию этих нормативно – справочных материалов. После их применения, в будущем будут проведены проверки.

В этот справочник включен минимальный набор данных (см. Приложение 6), и он ляжет в основу будущей проверки со стороны траста или совета здравоохранения. SCTN будет оказывать помощь трастам и советам, создавая программное обеспечение сбора данных и определяя доступные для них данные, а также будет налаживать связи с аудиторскими группами на местах для обеспечения непрерывного процесса аудита по всей Шотландии. Трасты и советы здравоохранения обязаны предоставлять персонал и денежные средства для сбора этих наборов минимальных наборов данных в отдельных учреждениях и регионально.

Комментарии рабочей группы.

В Украине существует специально утвержденная медицинская документация для регистрации и наблюдения онкологических больных ^221,222.


19.3 Индикаторы исходов

Минимальный набор данных, приведенный в Приложении 6, позволяет установить несколько клинических показателей. Самые проверенные, реальные и измеряемые данные должны быть документально оформлены, и это относится к случаям полного выздоровления без проявления рецидивов. Необходимы дальнейшие поиски по определению конечных клинических показателей, особенно по их совместимости с требованиями HRQL.


19.4 Памятки для пациентов

В помещениях больниц критерии допуска к клиническим опытам должны быть помещены для нужд медработников в отделениях, амбулатории и стационаре. Информация о психологических потребностях пациентов также должна быть доступна в этих местах.


19.5 Непрерывное профессиональное развитие

Весь персонал в общественных организациях и медицинских учреждениях (врачи, медсестры, фармацевты и консультанты) должны постоянно повышать уровень знаний, участвуя в конференциях, изучая распространяемые печатные материалы, результаты клинических исследования и проверок. Должна также существовать практика регулярного обсуждения передового опыта в государственном масштабе на открытых для участия форумах.


19.6 Информация для пациентов

Информация о группах поддержки, телефонах помощи и печатных материалах дана в Приложении 5.


19.7 Обучение населения здоровому образу жизни

Материалы о здоровье должны находиться в отделениях первичной помощи, онкологических центрах и отделениях. Эти материалы, в частности о том, что нужно знать о молочной железе, о Национальной программе скрининга молочной железы, должны быть доступны пациенткам и всем желающим.


СПИСОК ЛИТЕРАТУРЫ


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