三级医院的预先护理和复苏计划:一种多式联络方法
Sarika Suresh1, Angela Au1, Sharanya Mohan1
1Concord Repatriation General Hospital, Concord, New South Wales, Australia.
BMJ supportive & palliative care
|August 8, 2023
概括
预先护理规划 (ACP) 文档在多式联络干预后住院患者中显著改善. 这项临床审计显示,死亡前经过记录的ACP讨论数量有所增加,突出显示了更好的患者护理计划.
科学领域:
- 医学审计 医学审计
- 改善临床实践的改善
- 患者护理规划 患者护理规划
背景情况:
- 预先护理规划 (ACP) 涉及记录患者对未来医疗状况恶化的治疗偏好.
- 有效的ACP对于尊重患者的自主权和确保一致的医疗保健至关重要.
- 之前的审计突出了非最佳的ACP讨论和文档率.
研究的目的:
- 评估多式联络干预措施对改善医院住院患者的ACP讨论和文档的影响.
- 为了比较当前的ACP实践与2011年和2016年之前的审计数据.
- 确定在ACP进程中进一步增强的领域.
主要方法:
- 2021年在澳大利亚悉尼的一家三级医院进行了临床审计.
- 审计的重点是住院期间死亡的住院患者.
- 数据与2011年和2016年审计的调查结果进行了比较,以评估干预的有效性.
主要成果:
- 死亡前的ACP记录在2021年增加到97%,高于2016年的80%.
- 在入院后24小时内填写"不适用于复苏" (NFR) 文件的比例在2021年上升至65%,而2016年为33%.
- 虽然纸张复苏表格的使用率很高 (94%),但部分填写和贴纸的使用表明文件处理仍存在挑战.
结论:
- 多模式干预导致患者死亡前ACP的流行率和及时性显著改善.
- 进一步的干预工作将集中在完善非洲和非洲国家和地区的文件处理流程上.
- 计划在五年内进行后续审计,以维持和进一步加强非洲和非洲国家和地区的做法.
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