关于挪威养老院和急救机构之间的不合理和合理转移的共识领域:德尔菲研究
Arne Bastian Wiik1, Malcolm Bray Doupe2,3, Marit Stordal Bakken4
1Centre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway. arbaw@hvl.no.
BMC health services research
|March 27, 2024
概括
区分合适的养老院到紧急护理设施的转移是具有挑战性的. 这项研究建立了关于何时转移是合理的,自由裁量权的或不合理的共识,有助于临床决策和资源分配.
科学领域:
- 老年学是一门学科.
- 医疗保健管理的管理
- 临床决策 - 临床决策
背景情况:
- 对于临床护理的绝症病患者,老人院 (NH) 到紧急护理设施 (ECF) 的转移经常受到质疑.
- 优化NH到ECF转移可以使居民受益,并减少医疗保健系统的压力.
- 区分合理转移和不合理转移仍然是一个重大挑战.
研究的目的:
- 建立专家的共识,定义合理和不合理的养老院到紧急护理设施转移的场景.
- 为了使NH向ECF转移的术语"合理"和"不合理"成为可操作的.
主要方法:
- 德尔菲的一项研究涉及来自NHs的护士 (RNs) 和医生 (MDs),工作时间以外的初级保健 (OOHs) 和急诊室的医生.
- 利用基于现有文献的12种情景和11种医疗条件的精细列表.
- 在三轮Delphi中使用描述和比较统计数据分析数据.
主要成果:
- 在何时不转移居民方面达成了高度共识,在妄想情景方面达成了中度共识.
- 对于有必要的NH转移到ECF,只有很低的同意,除非有迹象表明可以进行缓解疼痛的手术.
- 在特定场景中,卫生专业人员,性别和农村地区的共识有显著差异.
结论:
- 从养老院到紧急护理机构的转移可以分为有必要的,自由裁量权的或没有必要的.
- 这些类别为操作化转让决策提供了一个框架.
- 这些发现旨在提高NH对ECF转移的适当性.
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