陷入过渡期:临床和患者因素导致医护人员长时间转移到急诊室,转移护理
Ryan P Strum1, John McPhee1, Michael Wionzek1
1Toronto Paramedic Services, City of Toronto, Toronto, Ontario, Canada.
Prehospital emergency care
|January 9, 2025
概括
患者从护理人员转移到急诊室的延迟不成比例地影响了老年人和医疗复杂的人. 有针对性的干预措施对于减少长时间的TOC时间和改善紧急医疗服务至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 护理人员服务面临着重大挑战,因为在急诊室 (ED) 患者的转诊时间 (TOC) 较长.
- 这些延迟阻碍了应急响应能力,但特定的患者和临床因素导致这些延迟并未得到充分理解.
研究的目的:
- 检查所有护理人员运送到急诊室 (ED) 的患者转移护理 (TOC) 时间.
- 为了确定与 TOC 持续时间延长相关的患者和临床因素.
主要方法:
- 一项回顾性队列研究分析了多伦多护理服务 (2022年9月 - 2024年7月) 的护理人员呼叫数据.
- 包括所有 9-1-1 运送到 ED 的患者记录,不包括设施间转移和丢失的 TOC 时间.
- 多变量逻辑回归确定了与超过60分钟的TOC相关的因素,包括对老年人的小组分析.
主要成果:
- 分析了超过4.18万辆运输;平均TOC为39.9分钟.
- 年龄较大 (≥75岁),医疗复杂性较高 (≥9个诊断),多种药物和特定的投诉 (例如,意识改变,呼吸困难) 独立地与长时间的TOC (≥60分钟) 相关.
- 医疗敏度和护理干预没有与长时间的TOC有关.
结论:
- 延长的TOC时间不成比例地影响老年和临床复杂的患者,无论他们的敏度如何.
- 开发有针对性的护理模式和加强护理服务与医院之间的合作,对于缓解这些延迟至关重要.
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