2017 Volume 18 Issue 3 Pages 160-166
This study places nurses in a community medicine cooperation office in hospitals, aiming to strengthen the cooperation system between the hospitals and welfare nursing facilities for the elderly.
We placed full-time nurses in medium-sized cooperative hospitals responsible for providing a plurality of care in the elderly welfare facilities of the region (hereafter referred to as “nursing homes” ). Although the regional medical cooperation office had been staffed by full-time social workers, as patients discharged from hospitals in states requiring medical procedures increased, there was a need to allocate nurses in the office to provide full-time discharge support. A full-time nurse with visiting-nurse experience working in a ward that had accepted many of the nursing home residents in collaboration with the appointed hospital was appointed to this position.
The appointed full-time nurse extracted issues regarding cooperation through meetings with nursing homes. In addition, the reality of the facility care was confirmed by actual visits to the nursing homes. It was revealed that medical procedures were conducted according to nursing-home nurses' working hour because there were no night-time nurses. There is no placement policy of the night-time nurses in nursing homes, and there was a discrepancy in the medical assistance method of patients between hospitals and nursing homes. To solve the deviation of the hospitals and nursing homes, a full-time nurse regularly provided a course of treatment and nursing information to nursing-home nurses, and nursing homes helped to allow preparation for proper re-admission. In addition, a full-time nurse, to strengthen the hospital system, launched a discharge support nurses association aimed at development of nurses with knowledge on patients' life in nursing homes. Appointment of a full-time nurse to regional medical cooperation scheme proved to be effective.
