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48 Musculoskeletal & Neurological Rehabilitation KCE reports 57 Figure 4.2: Fingerprint of an average Belgian “neurological” rehabilitation department (1998) (Source: Federale Overheidsdienst (FOD) Volksgezondheid, Veiligheid van de Voedselketen en Leefmilieu: https://portal.health.fgov.be/portal/page?_pageid=56,698710&_dad=portal&_schema=PORTAL#fb20 00) Each individual hospital department can be compared to this general picture. Figure 4.3 presents (as an example) the fingerprint of the locomotor and neurological rehabilitation departments of a large academic university centre.
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 49 Hygiëne Mobiliteit Uitscheiding Voeding Sondevoeding Bijzondere M ondzorg Decubitus preventie Dagkledij Canule zonder KV Canule met KV Anamnese Zelfst. Training Occ. Zelfst. Training Prog. Emotionele Crisis Desorient. passief Desorient. actief Isolatie Vitale Parameters Fysische Parameters Tractie/gips Bloedpuncties M edikatie IM /SC/ID M edikatie IV Infuus Chirurgische wonde Opp. Traum. wonde Traumatische wonde Figure 4.3: Fingerprint of the locomotor (left) and neurological (right) rehabilitation departments of a large Belgian academic university centre (1998). -0,5 -0,3 -0,1 0,1 0,3 0,5 Hygiëne Mobiliteit Uitscheiding Voeding Sondevoeding Bijzondere M ondzorg Decubitus preventie Dagkledij Canule zo nder KV Canule met KV Anamnese Zelfst. Training Occ. Zelfst. Training Prog. Emotionele Crisis Deso rient. passief Desorient. actief Iso latie Vitale Parameters Fysische Parameters Tractie/gips Bloedpuncties M edikatie IM /SC/ID M edikatie IV Infuus Chirurgische wonde Opp. Traum. wonde Traumatische wonde -0,5 -0,3 -0,1 0,1 0,3 0,5 The graphs show a small difference of the units on detailed aspects, but the overall picture for the different rehabilitation units remains the same. This graph illustrates that hospital units can be profiled using the minimal nursing data. As such it could be considered to reflect further on this profiling in order to get more rehabilitation specific information. 4.3.3 Revision of the Belgian Nursing Minimum Data Set Due to important changes in hospital practices, and percieved shortcomings of the original BNDMS, a revision of the data set is prepared . The process of revising the (B-NMDS) started in 2000. The Nursing Interventions Classification (NIC) was selected as a framework for the revision of the original BNMDS. Different items were seen as priorities for the revised BNMDS: hospital financing, nurse staffing allocation, assessment of the appropriateness of hospitalisation, and quality management. The revised version (MVG-RIM2) will allow a more detailed profile of the patients. The instrument is built on 4 levels. It is an open registration of 76 items (as opposed to the 23 in the MVG-RIM1). Each of the 76 items hold two or more aspects. These 76 items are grouped in 21 classes and 6 domains. (see Appendix to chapter 4) Nationwide implementation of the new MVG is foreseen the earliest by January 2008. 122 MVG-RIM2 (see Appendix to chapter 4) is expected to be able to respond in a more exhaustive way to document the nursing care needs of the patients, including cognitive aspects. It would also enable to compare “what has to be done” with “what is done”. It is also expected that MVG-RIM2 is a registration that enables to document the intensity of nursing care both needed and offered. However, the MVG-RIM2 is not a tool enabling to score for other paramedical (occupational training, physical therapy, psychology,…) and social needs and activities. Moreover an ongoing preliminary analysis of potential use of MVG-RIM2 on geriatric wards (KCE), seems to indicate that MVG-RIM2 is not a tool to monitor or assess the effectiveness of therapy and different aspects of rehabilitation activities. Last but not least, it is developed for use in hospitals, and does not allow to collect information on ambulatory services (except some specific day hospital activities).
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Dépôt légal : D/2007/10.273/19
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35. Etude relative aux coûts poten
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