足够安全:医疗复杂性患者在医院出院时的主观决定
Holly Hòa Võ1,2, Rebecca R Seltzer3,4, Maya Scott1,5
1Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.
在机械通风系统下放出儿童需要平衡安全与家庭自主权. 通过综合方法重新考虑安全评估,可以改善医疗复杂儿童的社区重新融入.
科学领域:
- 儿科重症监护 儿科重症监护 儿科重症监护
- 医疗保健伦理学 医疗保健伦理
- 医疗服务研究 医疗服务研究
背景情况:
- 由于高发病率/死亡风险,需要通过气管切除术进行机械通风的儿童的出院计划是复杂的.
- 临床指南建议持续监测护理/护理人员,但缺乏导致出院延误.
- 这就长期住院,不充分的支持或长期护理安置造成了伦理困境.
研究的目的:
- 探讨确定机械通风的儿科患者安全出院计划的挑战和伦理考虑.
- 倡导修订安全评估方法,尊重患者的自主权和公民权利.
- 促进临床团队和家庭之间的共同决策.
主要方法:
- 对伦理冲突和临床实践挑战的定性分析.
- 对社区融合和父母权利的法律义务的审查.
- 探讨影响家庭评估的偏见和种族主义.
主要成果:
- 当前的安全评估可能会导致意外的延迟和道德冲突.
- 偏见和种族主义会影响人们对家庭提供护理能力的看法.
- 压倒性的父母决定可能会造成伤害并破坏信任.
结论:
- 需要一种协作,综合的方法来定义"安全"排放.
- 临床团队和家庭之间对最佳实践和价值观的共同理解至关重要.
- 尊重自治和公民权利对于成功重新融入社区至关重要.
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