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关于PICU转移的设施间推通讯
Caitlin K Thirnbeck1, Elizabeth T Espinoza2, Elizabeth A Beaman3
1Division of Critical Care, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL.
对于急需的儿科机构间转移到儿科重症监护室 (PICU) 的口头转移与医院内转移有相似之处,但缺乏高质量的沟通的关键要素. 需要有结构的工具来改善PICU转移沟通和患者的治疗结果.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗保健的沟通 医疗保健的沟通
- 患者转移协议 患者转移协议
背景情况:
- 对于需要转移到更高水平护理的患者来说,有效的设施间沟通至关重要.
- 紧急转移到儿科重症监护室 (PICU) 需要介绍和接收临床医生之间的清晰简洁的信息交换.
研究的目的:
- 在紧急的设施间转移儿童到PICU时,描述口头交换.
- 为了将这些转移与高质量的医院内部轮班转移的既定元素进行比较.
主要方法:
- 一个混合方法的回顾性研究,分析音频录制的转诊电话.
- 涉及儿童病人的紧急机构间转移到学术三级转诊 PICU.
- 从2019年10月到2020年1月的4个月内收集的数据.
主要成果:
- 推电话的平均时间为9.7分钟,大多数临床医生提供了病史,检查和干预细节.
- 较少的临床医生明确讨论了疾病严重程度 (87%) 或代码状态 (19%).
- 沟通往往涉及间接引用,PICU入院的理由,并解决不确定性,不同于高质量的医院内部交换.
结论:
- 设施间的PICU转介通信与医院内部的转介通信有一些特征,但并不总是符合高质量标准.
- 需要开发和评估针对PICU设施间传输量身定制的结构化通信工具.
- 改善沟通对于在重症监护转移期间改善患者结果至关重要.
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