偏远医院的鼻腔高流疗法:使用修改后的Delphi技术制定指南
Sally West1, Donna Franklin2, Nichole Harvey3
1Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Qld 4825, Australia sally.west@jcu.edu.au.
Rural and remote health
|January 29, 2024
概括
一项新的临床指南改善了澳大利亚偏远医院缺乏儿科重症监护室 (PICU) 的儿童的鼻腔高流量 (NHF) 治疗. 这一举措增强了对重要呼吸系统支持的一致和公平获取,改善了重症儿童的健康结果.
科学领域:
- 儿科重症监护的儿童重症监护
- 农村和偏远地区的卫生服务.
- 呼吸系统药物 呼吸系统药物
背景情况:
- 偏远的澳大利亚医院缺乏现场儿科重症监护室 (PICU),需要空中医疗检索以获得三级护理.
- 鼻高流 (NHF) 治疗对于儿科呼吸道疾病至关重要,但在昆士兰农村地区,其实施不一致.
- 需要在偏远地区标准化NHF治疗方案,以确保平等获得护理.
研究的目的:
- 为在托雷斯海峡和约克角的三个偏远医院实施NHF治疗制定特定环境的临床指南.
- 改善偏远地区患有急性呼吸困扰的儿科患者获得NHF治疗的一致和公平机会.
- 解决与治疗延迟和偏远医疗机构服务获取限制相关的挑战.
主要方法:
- 采用了经过修改的Delphi技术,涉及远程临床医生,检索专家,儿科医生和NHF治疗专家的专家小组.
- 进行了反复的圆桌讨论,以制定远程特定的指南.
- 该过程包括文献审查和专家就关键实施问题达成共识.
主要成果:
- 在关键方面,包括护理环境,药物使用,员工培训,观察制度和咨询频率等方面,做出了远程特定的决定.
- 制定了指导方针,以减轻当地治疗安排和航空医学检索的延迟.
- 制定了战略,以应对有限培训人员,人员数量和供应链问题等挑战.
结论:
- 通过使用修改后的Delphi技术,成功开发了远程医院NHF治疗的上下文化临床指南.
- 该指南旨在通过减少工作场所实践延误和改善获得培训人员和资源的机会来提高一致性和安全性.
- 预计本指南的实施将改善偏远地区急性呼吸困扰儿童的健康和社会结果.
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