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创伤重症监护病房的最佳情况/最坏情况沟通工具
Melanie L Fritz1, Alexandra H Hernandez2, Amy B Zelenski3
1Department of Surgery, University of Wisconsin-Madison, Madison.
JAMA surgery
|September 24, 2025
概括
最好的情况/最坏的情况-ICU (BC/WC-ICU) 工具改善了严重受伤患者的沟通. 虽然对家庭来说是可行的和有益的,但时间限制和沟通恐惧等障碍妨碍了创伤重症监护室的广泛采用.
科学领域:
- 创伤重症监护中心的重症监护中心.
- 临床沟通策略 临床沟通策略
- 患者和家庭的支持.
背景情况:
- 有效的沟通对于严重受伤的重症监护病房 (ICU) 的老年人至关重要.
- 实施先进的沟通工具需要创伤小组成员的支持.
研究的目的:
- 评估最佳情况/最坏情况-ICU (BC/WC-ICU) 沟通工具的实施情况.
- 评估创伤重症监护室BC/WC-ICU工具的可行性和影响.
主要方法:
- 在一项随机临床试验中,使用BC/WC-ICU工具进行质量改善研究.
- 在8个美国创伤中心为创伤小组成员提供了超过12个月的培训.
- 范围,有效性,采用,实施和维护 (RE-AIM) 结果的评估.
主要成果:
- 在BC/WC-ICU干预达到大约1300个患者家庭,临床医生报告改善的预后沟通和决策.
- 网站的附加率各不相同 (45%-100%),在使用图形辅助工具时具有高保真度.
- 障碍包括竞争任务,担心讨论预后,以及缺乏创新感,导致长期使用滞后.
结论:
- 在创伤ICU中实施BC/WC-ICU工具是可行的,并支持预后沟通,增强临床医生与家庭的关系.
- 解决诸如高患者敏度和沟通阻碍等障碍对于未来的沟通改进工作至关重要.
- 该BC/WC-ICU工具显示了改善重症患者及其家属护理的潜力.
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