在COVID-19大流行期间医院间转移决策:质量研究
Emily A Harlan1,2,3, Eman Mubarak4, Janice Firn5,6,4
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA. schwessi@med.umich.edu.
Journal of general internal medicine
|May 30, 2023
概括
由于资源稀缺,医疗保健工作者在医院间患者转移期间缺乏指导,因此面临道德困境. 改进转移流程可以缓解这种困扰,并确保公平的患者护理.
科学领域:
- 医疗保健管理的管理
- 医学伦理 医学伦理
- 公共卫生 公共卫生
背景情况:
- 医院间患者转移可以通过将患者与专业资源联系起来来改善结果.
- 对于在资源稀缺期间优先考虑患者转移,特别是在流行病激增期间,存在有限的指导.
研究的目的:
- 探索医疗保健工作者在流行病激增期间与医院间患者转移的经验.
- 确定影响接受医院间患者转移的决策的因素.
主要方法:
- 使用与参与转移接受的医生,护士和管理人员进行半结构面试的定性研究.
- 在2021年10月至2022年2月期间,与密歇根州15家医院的21名参与者进行了采访.
主要成果:
- 出现了三个关键主题:决策者,患者和环境因素影响了转移决策.
- 决策者报告说,缺乏明确的指导,影响了患者的选择,并造成了道德上的困扰.
- 资源稀缺,组织变化和虚拟护理替代方案是重要的环境因素.
结论:
- 医院间转移缺乏标准化的指导,导致医疗保健专业人员的变化和道德困境.
- 调查结果表明,组织变革可以改善转移流程并减轻道德困境.
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