已完成的RESPECT计划是否有助于以人为中心的护理? 在英国一般实践中对已完成的计划进行评估
Caroline J Huxley1, Karin Eli1, Claire A Hawkes2
1Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom.
Resuscitation plus
|October 4, 2024
概括
建议的紧急护理和治疗总结计划 (ReSPECT) 计划的记录不一致,只有57%的计划完全记录了患者的偏好. 这影响了以人为中心的护理,强调了需要为临床医生提供更好的文档培训.
科学领域:
- 医学伦理 医学伦理
- 患者护理规划 患者护理规划
- 医疗保健服务研究 医疗服务研究
背景情况:
- 紧急护理和治疗的建议总结计划 (ReSPECT) 旨在记录患者对未来紧急护理的偏好.
- 此前在急症医院的研究发现了ReSPECT计划文档中关于患者偏好和推的理由的不一致性.
研究的目的:
- 评估 ReSPECT 建议与计划中记录的个人偏好相一致的程度.
- 评估关于RESPECT计划中患者价值观和偏好方面的文档质量.
主要方法:
- 分析了来自英格兰11家全科医院的141个RESPECT计划.
- 调整了以前的评估工具,以评估自由文本部分的清晰度,一致性和偏好和建议之间的一致性.
- 检查患者咨询和记录个人偏好.
主要成果:
- 57%的RESPECT计划记录了患者的偏好,尽管94%记录了咨询.
- 临床建议在31%的计划中直接反映了记录的偏好,在30%的计划中是一致的,在6%的计划中使用了相同的措辞.
- 在ReSPECT计划促进以人为中心的护理的潜力和当前的记录实践之间存在很大的差距.
结论:
- 虽然RESPECT的建议可以反映患者的偏好,但在超过一半的计划中不完全记录这些偏好,这阻碍了以人为中心的护理.
- 在RESPECT计划中对个人价值观和偏好进行更好的记录对于有效的共享决策至关重要.
- 未来的临床培训必须强调记录Respect计划的个人价值部分的重要性.
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