谁能得到床:影响重症监护退出区块的因素:一种定性研究
Frances Fengzhi Lin1, Jacqueline Peet2, Lauren Murray3
1Caring Futures Institute, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia; College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia; School of Health, University of the Sunshine Coast, 90 Sippy Downs Dr, Queensland 4556, Australia.
从重症监护室 (ICU) 出院的延误是常见的. 关键障碍包括沟通不良和资源问题,而明确的角色和团队合作有助于使患者从ICU流出更顺利.
科学领域:
- 医疗保健管理的管理
- 优化患者流量优化
- 重症监护室的运作 集中护理室的运作
背景情况:
- 患者流动的挑战,包括出院延误和下班后出院,是重症监护病房 (ICU) 的重要问题.
- 这些延迟与 ICU 和医院住院时间的增加,医疗保健成本的增加以及潜在的患者结果的恶化有关,包括再入院和死亡率.
- 影响ICU放电过程的因素仍然不完全理解.
研究的目的:
- 探索影响成年重症监护单位患者出院过程的障碍和促进因素.
主要方法:
- 一项定性,探索性,多站点的观察性研究,在澳大利亚昆士兰州的三个区域成人重症监护室进行.
- 数据收集包括员工采访,字段笔记和文档分析.
- 分析采用了演性内容分析 (结构,过程,结果框架),其次是诱导性分析 (理论领域框架).
主要成果:
- 对59个工作人员采访和放任文件的分析确定了影响放任的四个关键领域:背景/资源,对后果的信念,角色/身份和行为监管.
- 确定的障碍包括床位的可用性,信息系统的碎片化,团队间沟通不良以及决策不一致.
- 辅导员包括明确的专业角色,有效的ICU内部沟通,以及特定环境的放电策略.
结论:
- 结果提供了对ICU放电障碍和促进者的全面了解.
- 建议采取多方面的策略,以确保ICU的安全和高效排放,包括明确的指导方针,改进的数字通信系统和主动的排放计划.
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