远程选:一种定性研究,探索药剂师在毒素信息中心的临床决策,采用采访和临床图片
Qi Xuan Koh1,2, Sarah Wise2,3, Deborah Debono3
1Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia.
International journal of clinical pharmacy
|September 20, 2025
概括
毒素信息 (SPI) 专家使用动态临床判断来进行远程分离,平衡风险和背景. 他们的决策是由经验,指导方针和协作塑造的,影响培训和远程医疗服务.
科学领域:
- 药理学和毒理学 药理学和毒理学
- 医疗保健管理的管理
- 临床决策科学 临床决策科学
背景情况:
- 毒素信息专家 (SPI),主要是药剂师,经营澳大利亚毒素信息中心 (PIC).
- 他们提供基于电话的临界分拣 (远程分拣) 和对毒素暴露的管理建议,作为紧急服务.
- 关于药剂师如何在繁忙的远程分离紧急情况下应用临床决策的研究有限.
研究的目的:
- 调查SPI在远程选过程中如何利用临床判断.
- 确定影响SPI决策流程的因素,以管理毒素暴露.
主要方法:
- 一项定性研究,混合方法设计的第二阶段,专注于老年人 (≥75岁) 的无意中毒,致电新南威尔士州PIC.
- 对12名SPI进行了半结构化采访,使用临床图片作为支持.
- 专题分析与流程映射相结合,用于界定决策过程.
主要成果:
- SPI采用灵活,代的三阶段过程:信息收集,风险分层和管理决策.
- 决策受到经验,临床知识,呼叫紧迫性,风险评估和呼叫者信息解释的影响.
- 虽然指导方针确保了一致性,但SPI重视临床自主性,大学文化和同行学习对技能发展至关重要. 时间压力和文档需求带来了工作流的挑战.
结论:
- SPI决策是一个动态的,取决于背景的过程,整合了临床专业知识,指导方针和实时判断.
- 调查结果表明,对于复杂风险评估的SPI培训,文档系统和远程医疗服务设计需要改进.
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