"没有检测到异常":对应急部门编码实践的混合方法检查,用于自杀危机中的人
Molly McCarthy1, Pooja Saini1, Prof Rajan Nathan2
1School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK.
概括
紧急部门 (ED) 对自杀危机的编码通常是不准确的,误解了患者的需求,并阻碍了护理. 改善这些编码实践对于患者的福祉和资源分配至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 心理健康服务 心理健康服务
- 医疗信息学 医疗信息学
背景情况:
- 在急诊室 (ED) 准确编码自杀危机呈现对于及时提供心理健康支持和评估自杀预防工作至关重要.
- 目前ED的糟糕编码实践妨碍了适当的患者护理和数据完整性.
- 了解编码实践和影响因素对于改善患者治疗结果至关重要.
研究的目的:
- 检查紧急部门当前的与自杀有关的编码实践.
- 为了确定影响员工决策的因素,编码自杀危机呈现.
- 确定自杀危机患者编码不正确或缺失的原因.
主要方法:
- 采用混合方法方法,将ED出席率的定量分析与定性半结构面试相结合.
- 针对编码准确度,分析了来自6个英国EDS (2019-2021) 的15411名参加者的定量数据.
- 与23名ED工作人员进行了半结构面试,以探索编码决策过程.
主要成果:
- 很大一部分自杀危机表现的错误编码:21.8%为"抑郁症",3.8%为"焦虑症".
- 许多陈述缺乏适当的代码,被编码为"没有检测到异常" (23.6%) 或空白 (18.4%),也使用了身体伤害代码.
- 定性发现表明,资源限制和记录过程中的问题导致编码不准确.
结论:
- 患有自杀危机的患者经常没有收到反映他们出院的主要原因的代码.
- 提高ED编码实践的自杀危机可以显著有利于患者,并优化对干预的资源配置.
- 提高编码准确度对于有效的心理健康支持和自杀预防策略至关重要.
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