Notizie di Esteri in tempo reale - Pag. 154

Netanyahu annuncia la terza fase della guerra: l’esercito avanza a GazaStudio Aidomus-It: il 90% dei pazienti promuove l'assistenza infermieristica domiciliare di Adnkronos   10-07-2024 - 11:16 Link copiato #iubenda-cs-banner .iub_ts_bc:not(.iubenda-custom-content) *,Economista Italiano#iubenda-cs-banner [class*=" iub"],#iubenda-cs-banner [class^=iub],.iubenda-tp-btn:not([data-tp-nostyle]){ 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(Adnkronos Salute) - L’assistenza domiciliare infermieristica funziona: il 91,7% dei pazienti è soddisfatto e la promuove. Nelle Asl le Case della comunità sono ancora poco diffuse (solo nel 27,3% delle aziende), va un po’ meglio per i servizi di sanità digitale (presenti nel 57,1% delle Asl), ma il 92,2% garantisce comunque le cure a domicilio con personale infermieristico. Sono i principali risultati della prima analisi sull’assistenza infermieristica domiciliare in Italia Aidomus-It - ‘Il contributo dell’infermieristica per lo sviluppo della territorialità’ - condotta per 10 mesi del 2023 dal Cersi, Centro di eccellenza per la ricerca e lo sviluppo dell’infermieristica, che ha raccolto ed elaborato i dati su mandato della Federazione nazionale degli ordini delle professioni infermieristiche (Fnopi). L’indagine a cui hanno aderito 77 Asl su 110, pari al 75,3% della popolazione italiana, è articolata in tre sezioni: la prima rivolta ai dirigenti delle professioni sanitarie per analizzare gli aspetti organizzativi dell’assistenza domiciliare; la seconda agli infermieri, per rilevare le caratteristiche professionali, della loro attività lavorativa e delle condizioni di lavoro; la terza, rivolta ai pazienti per rilevare la qualità e la soddisfazione dell’assistenza ricevuta. Quasi la totalità dei pazienti - si legge in una nota - promuove l’assistenza ricevuta a casa: il 91,7% dichiara di essere sempre stato trattato con cortesia e rispetto dagli infermieri, l’86% di aver percepito che si stessero sempre prendendo cura di loro, l’83,3% di essere stato ascoltato attentamente, l’82% di essere stato sempre informato dagli infermieri su tempi e modi del loro intervento. Una valutazione complessiva sull’assistenza domiciliare ricevuta, espressa con voti da 0 a 10, ha meritato una media di 9,3 (con una punta del 9,4 negli anziani).Il numero medio di attività erogate per Asl è 10,1 su 17. Il percorso per il paziente oncologico è presente nel 40,3% delle strutture e le attività per i pazienti cronici sono erogate dal 74% delle Asl, mentre quelle per gli utenti con disabilità dal 59,7%. I servizi di infermieristica di famiglia e di comunità sono erogati dal 68,8% delle aziende mentre, il 26% delle Asl li codifica come ‘infermiere di prossimità’. La metà circa delle Asl eroga consulenze infermieristiche specialistiche e i servizi di sanità digitale risultano presenti in oltre la metà delle aziende (51,9%), di cui il 26% con attività di Teleassistenza.In quasi tutte le Asl sono inoltre garantite le attività di assistenza erogate dagli infermieri: prelievi ematici, medicazioni semplici e avanzate, somministrazione di farmaci, gestione di device, educazione terapeutica, sanitaria, formazione dei caregiver, monitoraggio e misurazioni delle condizioni di salute, valutazione delle condizioni familiari, cure palliative, procedure clinico assistenziali come gestione del catetere vescicale, gestione della nutrizione/dei dispositivi per la somministrazione di nutrizione enterale. Nelle cure domiciliari sono 49,5, su mille abitanti, gli over 65 presi in carico: 16,8 hanno gravi limitazioni per disabilità e 8,2 hanno patologie croniche. Più di 8 infermieri su 10 (83,8%) ha dichiarato di essere soddisfatto o molto soddisfatto del proprio lavoro: solo il 20,1%, se potesse, lascerebbe il lavoro nei successivi 12 mesi. Circa un terzo dichiara un carico di lavoro medio-alto mentre il 10,3% lo ritiene elevato. Rispetto al clima del gruppo di lavoro e la possibilità di erogazione di cure sicure, il 65,8% ha riportato punteggi migliori, con una media di 76,9. Rispetto alle condizioni psicosociali nei luoghi di lavoro, il 65,8% ha riferito una criticità media. Un infermiere su 5 dichiara di averne subito uno negli ultimi 12 mesi, ma il 36,9% ne ha subito tre o più nello stesso arco di tempo.Grazie alla capillarità delle rilevazioni, lo studio Aidomus ha potuto calcolare il costo giornaliero di un infermiere che opera nel servizio di cure domiciliari, comprendente il tempo speso a domicilio (circa 24 minuti ad accesso), quello per raggiungerlo, per ritornare presso la struttura e per le attività di back-office. Il valore, considerando 6,84 accessi/pazienti al giorno, è di 138,73 euro. L’adeguatezza delle stime di costo è stata comparata e confermata anche dall’analisi di 12 capitolati di gara a livello nazionale in 10 Regioni italiane da cui risulta che il costo giornaliero di un infermiere (anche considerando il costo-orario medio appaltato dalle Asl secondo capitolato di gara) è di 152,12 euro per 6,64 accessi. Quindi, se la gestione delle cure territoriali è a carico del Ssn si registra un risparmio e la sostenibilità economica si racchiude in una duplice azione: il valore dell’assistenza domiciliare infermieristica erogata e il mancato costo di ricoveri ripetuti di anziani e fragili.Lo studio inoltre consente di valorizzare economicamente il reale valore delle attività assistenziali svolte dall’infermiere al domicilio della persona: rapportandole al tariffario ambulatoriale del 2023, il valore della produzione garantita dagli infermieri è pari a 636,31 euro/giorno. Ne consegue che, in caso di mancata erogazione strutturata del servizio e ulteriore carenza infermieristica, si rischia di non poter garantire adeguatamente tali prestazioni in regime pubblico e convenzionato, costringendo il cittadino al ricorso all'out of pocket. Anche per questo la Fnopi ritiene necessario e strategico investire sulla professione infermieristica, sostenendola a tutti i livelli.“I dati organizzativi dello studio - afferma il Comitato centrale Fnopi - sottolineano la necessità di delineare modelli organizzativi condivisi ed efficaci, basati soprattutto sulle necessità delle differenti categorie di pazienti. I diversi livelli di staffing e skill mix condizionano l’efficienza della risposta del sistema assistenziale. È auspicabile - prosegue - l’implementazione di modelli che prevedano il coinvolgimento di infermieri con formazione specifica nelle cure territoriali”, data anche la soddisfazione espressa dall’utenza.“L’indagine condotta sulla soddisfazione degli infermieri rispetto al proprio lavoro - sottolinea Fnopi - impatta sulla ‘retentio’ degli infermieri stessi e dimostra una maggiore attrattività del setting domiciliare specifico. I dati rilevati sulle missed care (cure mancate) permetteranno, con approfondimenti futuri, di determinare i predittori delle nursing missed care sul territorio (anche riferiti alla singola attività) con ricadute positive sui costi dell’assistenza in termini di re-ricoveri impropri. Attraverso le strutture, per ora scarse, quali case della comunità o unità di degenza infermieristiche, sarebbe possibile incrementare la quantità e la complessità degli interventi erogati in ambito territoriale, senza il coinvolgimento delle strutture ospedaliere, con un evidente impatto in termini di risposte ai problemi di salute del cittadino e di riduzione dei costi sanitari. Oggi la distribuzione della tipologia di servizi disponibili e delle relative risorse - conclude la Federazione - non sembra essere sempre in linea con la densità abitativa e dunque con le richieste della popolazione, contrariamente a quanto sottolineato dalla letteratura riguardo alla necessità di adattare il più possibile i modelli alle esigenze dell’utenza”. di Adnkronos   10-07-2024 - 11:16 Link copiato Commenti Leggi la Netiquette

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