违背医疗建议离开:当前的问题和可行的解决方案
Shamma S Alhajeri1, Ibrahim A Atfah1, Ali M Bin Yahya2
1Emergency Department, Sheikh Khalifa Medical City, Abu Dhabi, ARE.
Cureus
|July 11, 2024
概括
违背医疗建议离开 (LAMA) 在急诊室很常见,通常是出于社会原因. 解决LAMA需要了解患者因素和改善医疗保健资源利用.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 患者的治疗结果.
背景情况:
- 违背医疗建议 (LAMA) 离开与不良健康结果和医疗资源利用率低下有关.
- 了解患者的人口统计和对LAMA的贡献因素对于改善护理至关重要.
- 目前的做法和围绕LAMA的当地准则需要评估.
研究的目的:
- 为了对患者进行单一中心的审计,他们违背了急诊室的医疗建议离开.
- 确定患者人口统计数据,并确定LAMA的贡献因素.
- 将发现与当地临床政策指南进行基准比较.
主要方法:
- 从2018年到2023年,对电子健康记录 (Salamtak®) 的回顾性审计.
- 120名患者的方便试点样本,他们从ED签署了LAMA.
- 数据收集包括人口统计,ED停留时间,保险状况,精神能力评估,LAMA的原因,PRO参与,重新参加和死亡率.
主要成果:
- 大多数LAMA病例 (80.8%) 发生在晚上/夜班期间.
- 社会原因 (37.5%) 是LAMA的最常见原因.
- 11.6%的患者在一周内再次接受治疗,没有报告死亡.
结论:
- 违背医疗建议离开是急诊室的一个重要问题,受到社会因素和ED运营方面的影响.
- 建议采用以患者为中心的方法,可能使用更少的耻辱化术语,如"早出院".
- 医疗保健提供者应熟悉当地指导方针,并为LAMA病例实施降低伤害策略和升级计划.
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