在慢性重症中实现护理决策的目标:一个多机构的定性研究
Sarah K Andersen1, Yanran Yang2, Erin K Kross3
1Program on Ethics and Decision Making, The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, AB, Canada.
Chest
|February 16, 2024
概括
在慢性严重疾病 (CCI) 中改善医疗保健目标 (GOC) 决策需要解决复杂,耗时的过程. 需要在系统层面做出改变,以加强医生沟通,减少阻碍中国政府更好的决策的障碍.
科学领域:
- 关键护理医学 关键护理医学
- 医疗决策的制定 医疗决策的制定
- 卫生系统研究 卫生系统研究
背景情况:
- 人们认识到有必要改善慢性重症患者的医疗目标 (GOC) 决策.
- 对于密集人员在CCI中促进中国政府决策所使用的流程了解有限.
研究的目的:
- 探讨强度医师如何在不同卫生系统为CCI患者促进中国政府的决策.
- 确定影响中国政府在CCI决策的障碍和促进者.
主要方法:
- 与来自美国和加拿大的6个机构的29名重症监护医生进行了半结构化采访.
- 采用了从决策科学中适应的心理模型方法.
- 诱导性定性描述用于分析采访成绩单.
主要成果:
- 中国政府在CCI中的决策是一个复杂,纵向和代的过程,涉及大量准备,多个利益相关者和众多家庭会议.
- 强化治疗者花费大量时间收集信息,达成预后共识,并在讨论中国政府之前与家人建立信任.
- 障碍包括短暂的员工模式,时间限制和沟通挑战;促进者包括定期的家庭会议,跨专业参与和一致的消息传递.
结论:
- 密集主义者从事复杂,劳动密集型的小组过程,用于中国政府在CCI中的决策.
- 改善信息共享和减少后勤/关系障碍的系统级干预对于加强中国政府在CCI中的决策至关重要.
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