关于救护医生在评估头部受伤的老年人时的看法,经验和决策过程的国家视角:混合方法研究
Jack William Barrett1, Peter Eaton-Williams2
1South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-0040-537X.
British paramedic journal
|December 4, 2024
概括
救护医生发现,老年人的头部伤害指南是处方性的,影响决策. 需要量身定制的指导和支持,以改善以患者为中心的护理,并减少不必要的急诊室运输.
科学领域:
- 紧急医疗 紧急医疗
- 老年人护理医院 老年人护理
- 在医院前的护理.
背景情况:
- 英国的救护车服务有各种各样的护理模式,急诊室 (ED) 运输率为40-60%.
- 头部受伤的老年人 (60岁以上) 的ED传输率很高 (60-70%),通常是轻微的伤害.
研究的目的:
- 探索救护车临床医生在评估头部受伤的老年人时的看法和决策过程.
- 确定影响该患者群体临床决策的因素.
主要方法:
- 混合方法使用在线调查和一对一访谈进行顺序解释设计.
- 调查数据从385名英国救护车临床医生收集到的经验,信心和看法.
- 采访为调查结果提供了更深入的见解.
主要成果:
- 临床医生经常评估头部受伤的老年人,对可见损伤充满信心,但对神经评估不那么自信.
- 对ED传输的信心很高,但对替代转诊或释放的信心较低.
- 关键主题:基于指导方针的与以患者为中心的护理,共享决策和安全网.
结论:
- 现有的ED传输指南被认为是规范性的,并且难以应用于老年人头部损伤个别病例.
- 需要更多以患者为中心的,整体的决策方法.
- 建议制定量身定制的指导方针和加强支持,以减少头部受伤的老年人不必要的ED运输.
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