简要提供者教育与超级用户ED访问减少有关
1University of South Dakota Sanford School of Medicine.
概括
紧急部门的阿片类药物处方教育减少了超级使用者 (SU) 和他们的访问人数. 这种干预措施显示出大大节省成本并改善紧急情况下的患者护理的潜力.
科学领域:
- 紧急医疗 紧急医疗
- 疼痛管理 疼痛管理
- 医疗保健政策 医疗保健政策
背景情况:
- 在急诊室 (ED) 中使用阿片类药物与类似诊断的30天返回率增加有关.
- 超级用户 (SUs) 压迫ED资源,影响患者的治疗结果.
- 医生在疼痛管理和阿片类药物处方方面的有限的正式培训需要改进教育策略.
研究的目的:
- 评估结构化阿片类药物处方教育对ED超级使用者的影响.
- 评估这种教育对资源利用和患者回访疼痛诊断的影响.
主要方法:
- 一个基于美国紧急医疗学会指导方针的课程在五个中西部ED中实施.
- 分析了回顾性 (第一阶段) 和前性 (第二阶段) 的非识别ED访问数据.
- 超级使用者被定义为为同一疼痛诊断多次ED访问的患者; 麦克内马尔的测试和Z-Score被用于分析.
主要成果:
- 对于同一诊断 (p=0.0006) 访问ED多次的患者,观察到统计学上显著的下降.
- 超级用户访问的总数显著下降 (p=0.0008).
- 对于同一个诊断的两三次以上重复诊断的患者,没有发现显著的变化.
结论:
- 阿片类药物处方教育与超级使用者访问ED的减少有关.
- 这种干预可以在多个ED中节省大量的成本 (估计超过100万美元).
- 教育可能对慢性ED使用者对疼痛的影响有限,这表明需要多方面的方法.
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