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预警指南的一致性有多大? 审查英国救护车服务指南
Aimée Boyd1, Fiona C Sampson2, Fiona Bell3
1South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0003-1030-8167.
British paramedic journal
|March 6, 2024
概括
英国的救护车服务显示,紧急部门 (ED) 的预警指南存在显著差异. 不一致的标准和不良的可访问性风险患者护理和资源分配. 迫切需要标准化,明确的指导.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健政策 医疗保健政策
- 救护车服务 救护车服务
背景情况:
- 救护车预警通知急诊室 (EDs) 需要立即注意的重症患者.
- 不适当的预警可以压迫ED资源,从其他危急患者的护理转移.
- 目前关于预警程序的指导是有限的,缺乏标准化.
研究的目的:
- 绘制和分析来自英国国家卫生服务 (NHS) 救护车服务的现有预警指南.
- 评估当前预警指南的一致性和可访问性.
- 识别预警标准的变化,并与国家建议保持一致.
主要方法:
- 联系了英国所有19个救护车服务机构,以获得预警指导文件.
- 审查和绘制指南,注意预警条件和与救护车首席执行官协会 (AACE) 和皇家紧急医疗学院 (RCEM) 的指南保持一致.
- 使用AGREE II工具评估语言和可访问性.
主要成果:
- 15个服务响应,10个服务提供了具体的预警指导.
- 在预警条件 (4-45个服务) 和不一致的内部标准中发现了显著的差异.
- 指南与AACE/RCEM建议不一致,有不同的生理值和术语.
- 文档质量不佳,在适用性和整体质量方面得分低于35%.
结论:
- 对于救护车预警的标准化,互补的政策和工具是非常需要的.
- 对于临床医生来说,单一的,可访问的文档对于准确的,时间关键的预警决策至关重要.
- 在英国的救护车服务中协调预警标准是必要的,以改善患者护理和资源管理.
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