CONGRESS ABSTRACT

The issue of chronicity and frailty is shaped in the current health care environment as an increase in the complexity of pz-users referred to Rehabilitation Cardiology. Advances in medical care and improvements in general living conditions have led to an explosion of chronic diseases and the spread of a new figure of the caregiver, in which several diseases coexist. For this reason, over the past 20 years, the need for care, in the R.C. has increased significantly precisely bc of the increase in multiple comorbidities of pz hospitalized for cardiologic events. This need translates into increased care complexity, which therefore requires the need to experiment with new organizational models capable of ensuring a systemic approach to taking care of the person. In this scenario, the PN of care is developed, an innovative method capable of going beyond the therapeutic project, centering the process from operator-centered to pz-centered. The essential aspect of this organizational model is the practitioner ‘s full acceptance of his or her responsibilities from admission to discharge of the pz. From August 2023 to November 2023, 228 consecutive pz were admitted to the RC. The PN organizational model was applied to all in pz admitted during the period under observation. During admission to the ward, the charge nurse, in full sharing with the pz, carried out data collection and planned care activities; in order to create guidance for colleagues who collaborated with the charge nurse in the care plan, the nurse implemented the drafting of the care process. Finally, in order to provide assurance of continuity of care and to ensure a safer and smoother return home or transfer to another facility for the pz and family members, the nurse, thanks to the PN, also planned the discharge, having personally followed the patient throughout the entire hospitalization. In order to assess the quality of care provided, a satisfaction questionnaire was administered to all in pz admitted during the period under observation. The mean age of the observed pz is 68.7 aa, 79% of pz observed had previous hospitalizations in other hospitals,no pz had any experience with PN, 98% of observed pz noted improved care with referral nurse intake,2% of pz did not complete the questionnaire.In our brief experience, the PN organizational proved to be an effective and comprehensive method, contributed to improving the quality of care provided in our OU and improved the satisfaction of staff