在急诊室出院后使用远程辅助医疗来进行家庭下降风险降低:初步数据
Lynn G Jiang1, Christina McGinnis2, Emily Benton1
1Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA.
Journal of the American Geriatrics Society
|July 9, 2024
概括
社区远程辅助医疗 (CTP) 有效地减少了老年人急诊部 (ED) 退院后的跌倒. 这项质量改进项目确定了家庭风险,并实施了缓解策略,在预防跌倒和相关医疗利用方面显示出有希望的结果.
科学领域:
- 老年病的医生 老年病的医生
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
背景情况:
- 从急诊室 (ED) 出院的老年人往往缺乏全面的跌倒风险评估.
- 一个质量改进项目利用现有的社区远程医疗 (CTP) 计划来弥补这一差距.
- 该CTP计划的重点在于在ED释放后对家庭下降风险的评估和减轻.
研究的目的:
- 实施和评估社区远程医疗 (CTP) 计划,用于急诊部 (ED) 退院后的老年人中跌倒风险评估和缓解.
- 为了确定老年患者在家庭环境中常见的跌倒风险因素.
- 评估CTP对落相关结果的可行性和初始影响.
主要方法:
- 患有高跌倒风险的患者 (STEADI评分>4) 被转介到CTP家庭访问,由急诊医生进行虚拟监督.
- 评估包括家庭危险,定时启动和启动 (TUG) 测试,药物调和和心理社会评估.
- 在出院30天后测量的结果包括CTP访问完成,跌倒,ED重新访问,住院和转诊.
主要成果:
- 104名患者被转介到CTP;59%的患者接受了初次访问,79%的患者进行了后续访问.
- 通常识别的风险包括异常的TUG测试 (74%),家庭危险 (67%) 和高风险药物 (36%).
- 在30天后,只有一个患者报告了跌倒,一个患有与跌倒相关的急救访问,一个因跌倒而入院.
结论:
- 使用CTP的质量改进计划有效地识别并解决了ED释放后老年人的家庭跌倒风险.
- 在家庭环境中,CTP模型显示了降落风险降低的潜力.
- 需要进一步的受控研究来证实CTP对临床结果的影响.
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