China's National Health Commission (NHC) issued a notice on Strengthening elderly care services on December 20, requiring local governments to increase the number of medical institutions and beds to provide elderly care services, and encouraging the development of a new business model of "Internet plus nursing services".

Background: There are over 40 million disabled elderly people in China

At present, there are nearly 250 million people aged 60 and above in China, and more than 40 million disabled elderly people, so the demand for old-age medical care is very urgent.

To further accelerate the establishment of a geriatric care service system covering the acute, chronic, rehabilitation, long-term care and the end of life of the elderly, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly formulated the Notice on Strengthening Geriatric Care Services.

Interpretation 1: Increase the number of medical institutions and beds

To this end, the notice requires that the number of medical institutions and beds providing geriatric care services should be increased, the supply of geriatric care services should be increased in medical institutions, the service capacity of geriatric care practitioners should be improved, and the service mode of geriatric care should be enriched.

                            It is urgent to increase the number of health care facilities for the elderly

The notice requires that in the planning and layout of medical resources, according to the number of elderly people in the area, the characteristics of disease spectrum, and the urgent needs for medical care, increase the supply of medical care resources for the elderly, encourage grass-roots medical institutions to add corresponding beds, and increase the number of medical institutions and beds providing old-age care services.

Interpretation 2: Increase the supply of elderly care services

At the same time, medical institutions will increase the supply of elderly care services. Medical institutions should provide professional, appropriate and convenient elderly care services for elderly patients according to the requirements of hierarchical diagnosis and treatment in combination with functional positioning.

                Combine medical care with nursing care, and promote quality nursing services

     Among them, tertiary hospitals provide specialized nursing services for elderly patients with             acute, critical and complicated diseases, and play a radiating and driving role.

      Encouraging level II hospitals to increase the number of beds providing geriatric care services. Nursing homes, rehabilitation hospitals, nursing centers and rehabilitation medical centers should provide medical care and long-term care services for elderly patients with a clear diagnosis and stable condition.

Primary medical and health institutions should provide nursing services for the elderly patients in need, especially the disabled elderly patients.

Interpretation 3: Improve the service ability of elderly care practitioners

The notice proposed to strengthen the training of clinical nurses in medical institutions, improve their elderly common diseases, frequently-occurring care, elderly psychological care and geriatric nursing professional technical level.

Accelerate the training of medical nurses, improve their professional quality and professional skills.

Interpretation 4: Enrich the elderly care service mode

The notice requires medical institutions to combine the promotion and requirements of high-quality nursing services, for the elderly inpatients to provide comprehensive, full responsibility system overall nursing services.

To encourage qualified medical institutions to actively provide continuity of care services for elderly patients.

We will support primary medical and health institutions in providing day care, home care and home hospital beds for disabled or elderly people. We will encourage the development of a new business model of "Internet + nursing services".

read

Training Program for Specialized Nurses in Geriatric Care (Trial)

Main contents of Training Outline for Geriatric Nursing Nurses (Trial) :

The training object, training target, training method and time, training content and assessment method and content are clearly defined. Primarily with all kinds of medical institutions at all levels is preparing work in aged care related or nurse, basic theory, basic knowledge of aged care, common geriatric syndromes and diseases of old age, psychological problems, such as hospice care theory knowledge, as well as common geriatric nursing technology and geriatric rehabilitation nursing clinical practice ability training. So that it can provide institutional and home care services for elderly patients in a standardized and professional manner.

I. Training objectives

In accordance with the regulations on nurses and other regulations and requirements for accelerating the development of geriatric nursing services, the training of professional geriatric nursing nurses has been carried out. The basic theory, knowledge and skills of geriatric nursing nurses should be improved through training. Good professional ethics, communication skills, emergency handling ability, etc. Master common geriatric syndrome, geriatric diseases, psychological problems and other nursing points, enhance the sense of humanistic care and responsibility, to provide institutional and home nursing services for the elderly patients in a standardized and professional manner.

Ii. Training object

Nurses who are working or planning to work in geriatric care in various levels of medical institutions.

Iii. Training method and time

(1) Training methods.

The training is a combination of theoretical knowledge training and clinical practice ability training.

(2) Training time.

At least 60 days of training for geriatric care professionals in secondary and above medical institutions, 360 credit hours in total. Among them, 20 days of theoretical knowledge, a total of 120 credit hours; Clinical practice ability training 40 days, a total of 240 credit hours.

At least 45 days of training for geriatric care professionals in secondary and lower medical institutions (such as community health service centers, nursing homes, medical institutions in the combination of medical and nursing institutions, etc.), a total of 270 credit hours. Among them, 15 days of theoretical knowledge, a total of 90 class hours; Clinical nursing practice training 30 days, a total of 180 hours.

Iv. Training content

(1) Theoretical knowledge training.

It mainly includes laws, regulations and policies related to geriatric care, rules and regulations related to geriatric care, basic theories and knowledge related to geriatric care, common geriatric syndrome, geriatric diseases, psychological problems and hosptial care care, guidance and support for home caregivers, safety management, etc. The specific training content and the allocation of credit hours are attached.

(2) Clinical practice ability training.

It mainly includes geriatric nursing techniques, geriatric rehabilitation nursing and clinical nursing practice. The specific training content and the allocation of credit hours are attached.

5. Assessment method and content

Assessment is divided into training process assessment and training completion assessment.

(1) Training process assessment.

Comprehensive evaluation of the performance of the training object in the process of receiving training. The assessment content mainly includes medical ethics, professional quality, humanistic care, theoretical study and clinical practice daily performance and phased completion, etc.

(2) Assessment of training completion.

After the training, the professional assessment is carried out for the training object, including the assessment of theoretical knowledge and clinical skills.

Theoretical knowledge evaluation mainly includes the aged care system of relevant laws, regulations and policies, aged care work related rules and regulations, aged care related basic theories, basic knowledge, basic skills, such as common geriatric syndromes and diseases of old age, psychological problems, such as hospice care nursing, home caregivers guidance and support, security management and so on.

Clinical practice ability assessment: 2 cases of common diseases of clinical senile patients were selected. According to the patient's situation and medical records, the main nursing problems were analyzed, and nursing measures and guiding points were put forward. Examine 2 commonly used geriatric care techniques.

Theoretical knowledge training content and credit hour allocation

1. Laws, regulations, policies and rules and regulations related to elderly care 3 credit hours

(1) Law of the People's Republic of China on The Protection of The Rights and Interests of the Elderly, Outline of the "Healthy China 2030" Plan, Guidance on Promoting the Reform and Development of the Nursing Service Industry, Notice on Carrying out The Assessment of the Needs of the Elderly Care and Standardizing Services, etc.

(2) Relevant rules and regulations of medical institutions, geriatric care related work system and geriatric care post responsibilities, etc.

2. Basic theory of elderly care 6 credit hours

(1) Overview of the elderly and aging society

(2) Characteristics and related theories of aging

(3) Communication skills and humanistic care for elderly patients

(4) Ethical issues related to elderly care

(5) Status and progress of elderly care work

3. Common geriatric syndrome nursing 40 credit hours

(1) weakness

(2) Cognitive impairment

(3) Sleep disorders

(4) Audio-visual impairment

(5) dizziness and syncope

(6) delirium

(7) Chronic pain

(8) Malnutrition

(9) urinary incontinence

(10) Constipation

(11) Fall down

(12) Stress injury

4. Common geriatric diseases nursing 40 credit hours

(1) Hypertension

(2) Coronary heart disease

(3) Acute myocardial infarction

(4) Heart failure

(5) Chronic obstructive pulmonary disease

(6) pneumonia

(7) Respiratory failure

(8) Stroke

(9) Parkinson's disease

Diabetes mellitus

(11) Gastroesophageal reflux disease

(12) Urinary tract infection

(13) Chronic renal failure

(14) Osteoporosis

anemia

(16) Rheumatoid arthritis

(17) Cataracts

(18) Pruritus

5. 10 credit hours of nursing for common elderly psychological problems

(1) Anxiety

(2) Depression

(3) Loneliness

6. Hospice care for the elderly 6 credit hours

(1) End-of-life comfort care for the elderly

(2) Deathbed grief counseling for the elderly

7. Home caregiver guidance and support 15 credit hours

(1) Home care ability assessment and guidance

(2) Communication skills guidance for home caregivers

(3) Stress relief and social support for home caregivers

Remark:

1. Geriatric care professionals in secondary and lower medical institutions (community health service centers, nursing homes, combined medical and nursing institutions, etc.) can choose the contents marked with "★" according to the actual situation.

2. Geriatric nursing professionals can choose the basic knowledge of traditional Chinese medicine related to geriatric nursing based on the actual situation (including basic knowledge of Traditional Chinese medicine, overview of Traditional Chinese medicine nursing, basic knowledge of meridians and acupoints, physical characteristics of the elderly, and traditional Chinese medicine nursing of common symptoms of geriatric diseases).

Clinical practice ability training content and class hour allocation

1. Commonly used geriatric care technology 40 hours

(1) Temperature measurement

(2) Pulse and respiration measurement

(3) Non-invasive blood pressure measurement

(4) Invasive blood pressure monitoring ★

(5) Ecg monitoring

(6) Subcutaneous injection

(7) Intramuscular injection

(8) Venous blood collection

(9) Blood glucose monitoring

(10) Intravenous indwelling needle puncture

(11) Maintenance of central venous catheter (PICC) via peripheral vein

(12) Oxygen inhalation

(13) Home oxygen therapy

(14) Atomization inhalation

(15) Effective sputum removal

(16) Placement of oropharyngeal snorkel

(17) Artificial airway fixation

(18) Nursing of tracheal intubation

(19) Sputum aspiration

(20) Indwelling gastric tube

(21) Nasal feeding

(22) Gastrostomy nursing

(23) Enterostomy care

(24) Indwelling catheterization

(25) Catheter maintenance

(26) Enema

(27) Anal exhaust

(28) Diabetic foot care

(29) Urine specimen collection

(30) Collection of stool specimens

(31) Sputum specimen collection

(32) Dressing the wound

(33) Oral administration

(34) Skin administration

(35) Intraocular administration

(36) Intraural administration

(37) Intranasal administration

(38) Oral administration

(39) Vaginal administration

(40) Vaginal irrigation

(41) Rectal administration

(42) Cold compress therapy

(43) Hot compress therapy

(44) Use of a walker

(45) Wheelchair use

(46) Lower diaphragmatic abdominal impact method

(47) Cardiopulmonary resuscitation

(48) Asynchronous electrical defibrillation

2. Geriatric rehabilitation nursing 20 credit hours

(1) Personal hygiene and cleaning training

(2) Dressing training

(3) Feeding training

(4) Good limb placement in hemiplegia patients

(5) Exercise in bed

(6) Range of motion training

(7) Transfer training

(8) Balance training

(9) Walking training

(10) Speech training

(11) Cognitive training ★

(12) Cardiopulmonary function training ★

(13) Pelvic floor muscle training

(14) Intestinal function training

3. Clinical nursing practice 180 hours

(1) Nursing practice of common geriatric syndrome

(2) Nursing practice of common geriatric diseases

(3) Nursing practice of common senile psychological problems

(4) Geriatric rehabilitation nursing practice

(5) Practice of hospice care for the elderly

Remark:

1. Geriatric care professionals in secondary and lower medical institutions (community health service centers, nursing homes, combined medical and nursing institutions, etc.) can choose the contents marked with "★" according to the actual situation.

2. Geriatric nursing professionals may choose auricular acupoint application, scraping, cupping, acupoint application and Traditional Chinese medicine application according to the actual situation. The above-mentioned traditional Chinese medicine nursing projects must be approved by the medical institution and used in accordance with the operating standards and requirements.

Main contents of Geriatric Nursing Practice Guide (Trial) :

Mainly for the elderly patients with common syndromes, common diseases, psychological problems, geriatric nursing technology, rehabilitation nursing and hosptial care, home care and other needs, clear assessment and observation points, nursing points, health guidance and home care points. To guide medical institutions at all levels to provide old-age care services and improve the quality and level of services.