标准化急诊室喘护理途径对医疗服务利用率的影响
Chanel Kwok1,2, Katherine Lajkosz3, Carole Madeley2
1Department of Medicine, University of Ottawa, Ottawa, Canada.
概括
实施基于证据的急诊室喘护理途径 (EDACP) 在安大略省的教学医院减少了2%的返回ED访问. 获得螺旋计和峰值呼气流量测试进一步减少了复诊,突出了标准化喘护理的重要性.
科学领域:
- 紧急医疗 紧急医疗
- 呼吸系统医学 呼吸系统医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 一个基于证据的标准化急诊室喘护理途径 (EDACP) 已在加拿大安大略省开发和实施.
- 标准化护理途径旨在改善患者的治疗结果和在紧急情况下的资源利用.
研究的目的:
- 评估实施EDACP对返回紧急部门 (ED) 访问的影响.
- 评估获得喘管理资源和专家对ED复诊的影响.
主要方法:
- 一项对173家安大略省医院的调查评估了获得喘专家和管理资源的机会,包括EDACP的实施.
- 省级卫生行政数据与调查数据联系在一起,以分析急性卫生服务的利用率.
- 使用波桑回归的中断时间序列分析被用来评估EDACP实施的影响.
主要成果:
- 在123家响应的医院中,44家 (35.8%) 采用了EDACP.
- 实施EDACP与在教学医院72小时7天内返回ED访问的2%减少有关 (p<0.05).
- 峰值呼气流量测试和精神测量与在72小时内返回急救诊所的几率显著降低有关.
结论:
- 大规模实施EDACP在各种环境中显示出积极的结果.
- 投资克服EDACP采用和实施的障碍是有必要的.
- 标准化喘护理途径和诊断工具对于减少重复的急救诊所访问至关重要.
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