在急诊部为老年人提出非特定投诉的护理途径的实施;多中心并行队列研究的协议
M G A M van der Velde1,2, M A C Jansen3, M A C de Jongh3
1Department of Internal Medicine, Máxima MC, Veldhoven, The Netherlands.
PloS one
|August 29, 2023
概括
在急诊部 (ED) 为有非特定病情 (NSC) 的老年人提供新的护理途径,旨在提高护理效率和质量. 这种结构化的方法旨在减少长时间住院和老年患者出现模糊症状的不良结果.
科学领域:
- 老年病的医生 老年病的医生
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 老年人经常以非特定的投诉 (NSC) 来到急诊室 (ED),导致延长诊断过程和长时间的ED停留.
- 这些患者面临更高的不良结果的风险,因为缺乏标准化的护理途径.
- 提出了一个结构化护理途径,以提高这种脆弱人群的急性护理的效率和质量.
研究的目的:
- 设计和评估一个结构化的护理路径,以老年人提出非特定的投诉 (NSC) 在急诊部 (ED).
- 评估该途径在提高护理效率方面的有效性,以在ED (LOS-ED) 停留时间来衡量.
- 评估对护理质量的认知和二次结果,包括住院时间和再接收率.
主要方法:
- 一项多中心并行队列研究,涉及全科医生,老年护理医生,急诊医生,老年医生和内科医生之间的合作.
- 纳入标准:年龄在70岁或以上,患有需要ED入院的NSC的患者.
- 护理途径包括风险分层 (APOP-screener),有限的综合老年病评估 (CGA),标准诊断和专门的ED护士.
主要成果:
- 主要结果包括在ED停留的时间 (LOS-ED) 和对护理质量的感知.
- 二次结局包括住院时间,再访,再入院以及30日和90日随访后的死亡率.
- 在路径实施之前,将追溯地纳入一个对照组,然后进行潜在的纳入.
结论:
- 拟议的结构化护理途径提供了一种新的方法来管理老年患者在ED的非特异性投诉.
- 该倡议旨在通过提高效率和患者报告的护理质量来优化急性护理的提供.
- 进一步评估将确定该途径对关键临床结果和资源利用的影响.
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