确定拒绝紧急医疗服务能力的关键步骤 运输:修改后的德尔菲研究
Eli A Carrillo1, Steven P Ignell1, Sharon Wulfovich1
1Department of Emergency Medicine, School of Medicine, Stanford University, Palo Alto, California.
Prehospital emergency care
|September 13, 2024
概括
紧急医生现在可以使用16个标准化步骤来评估拒绝救护车运输的患者的决策能力. 本指南确保了对紧急医疗服务 (EMS) 护理的严格和可行的评估.
科学领域:
- 医学伦理 医学伦理
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 紧急医生通常在没有专门的紧急医疗服务 (EMS) 培训的情况下提供医疗监督.
- 评估拒绝EMS运输的患者的决策能力是一个常见的伦理挑战.
- 对于严格和可行的能力评估,需要采用标准化的方法.
研究的目的:
- 在能力评估的指导问题和建议上达成专家共识.
- 为紧急医生制定标准化协议,评估拒绝EMS运输的患者.
- 确保一个严格和可行的能力评估过程.
主要方法:
- 修改后的Delphi方法被采用,在全国范围内有19名医生专家.
- 进行了两轮调查,并举行了一次虚拟会议进行讨论和改进.
- 共识被定义为专家之间80%的共识.
主要成果:
- 在第一轮之后,在19个项目中,就15个项目达成初步共识.
- 讨论的重点是整合患者关切 (成本,社会障碍) 和替代护理选择.
- 在第二轮之后,达成了16个标准化步骤的最终共识.
结论:
- 一个专家小组同意了能力评估的16个标准化步骤.
- 这些步骤将指导紧急医生评估拒绝EMS运输的患者.
- 该协议旨在提高实时患者评估的质量和一致性.
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