探索跨学科的沟通途径,以加剧医疗前急救队的恶化:一种混合方法的研究
Stephanie K Sprogis1, Judy Currey1, Daryl Jones2
1School of Nursing and Midwifery & Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia.
概括
临床医生在迅速响应系统中升级患者护理时,在沟通方面扎. 目前的方法,比如呼叫机,是不够的,阻碍了对病情恶化的患者及时干预.
科学领域:
- 医疗保健通讯 医疗保健通讯
- 患者安全 患者安全
- 快速响应系统 快速响应系统
背景情况:
- 有效的跨学科沟通对于及时升级患者护理至关重要.
- 快速反应系统 (RRS) 旨在改善病情恶化的患者的治疗结果.
- 医疗前应急队 (pre-MET) 层在早期干预中发挥着至关重要的作用.
研究的目的:
- 调查临床医生如何使用和感知沟通通路径,以在预MET层内的护理升级.
- 在升级过程中识别挑战和信息缺口.
- 评估当前通信方法对MET前恶化的充分性.
主要方法:
- 一个连续的混合方法研究,涉及观察和采访.
- 参与者包括护士,相关卫生专业人员,以及照顾骨科和通用医学患者的医生.
- 用描述性和主题分析分析了27个MET前事件和29个临床医生采访的数据.
主要成果:
- 在13个MET前事件中观察到升级做法,字母数字呼叫器 (61.5%) 和面对面的讨论 (30.8%) 是主要的沟通方法.
- 只有七个升级事件导致床边前MET审查.
- 临床医生报告说,由于沟通缺陷和信息缺口,导致升级存在重大挑战,阻碍了决策.
结论:
- 政策定义的升级路径不一致地用于MET前恶化.
- 现有的通信方法不足以满足临床医生对护理升级的需求.
- 加强通信基础设施和跨学科合作对于优化患者病情恶化管理至关重要.
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