在急性病医院实施黄金标准框架:生命终结结果
Louis Harpham-Lockyer1, Joanne Bowen2, Holly Sides3
1Palliative Medicine Department, The Dudley Group NHS Foundation Trust, Dudley, UK louis.harpham-lockyer@nhs.net.
BMJ supportive & palliative care
|October 23, 2025
概括
实施黄金标准框架 (GSF) 改善了预先护理计划 (ACP) 并减少了医院死亡. GSF编码有助于识别临终期患者的首选死亡地点,使护理与患者的愿望保持一致.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 医疗保健管理的管理
背景情况:
- 医院是英国最常见的死亡场所,30%的患者在生命的最后一年中死亡.
- 国家政策倡导早期识别和主动规划,以支持患者首选的死亡地点.
- 达德利集团NHS基金会信托基金会实施了黄金标准框架 (GSF) 来识别临终患者和指导护理.
研究的目的:
- 评估金标准框架 (GSF) 编码对预先护理计划 (ACP) 和死亡地点结果的影响.
- 评估GSF的实施是否影响患者护理与偏好保持一致.
主要方法:
- 对英国一家医院的成年住院患者的回顾性审查,这些患者在01/09/2023的12个月内死亡.
- 被归类为GSF编码或非编码的患者.
- 评估结果包括记录的ACP和死亡地点.
主要成果:
- 在216名已故患者中,104名 (48%) 患有GSF编码.
- 与没有编码的患者相比,GSF编码的患者 (绿色/珀色) 显示出更高的ACP文档 (54%对13%).
- 具有GSF编码的患者更有可能在医院外死亡 (65%对45%),这一趋势在癌症和非癌症诊断中一致.
结论:
- GSF的实施和编码有助于更早地识别生命周期结束.
- GSF编码与提前护理规划参与度增加有关.
- GSF编码与减少医院死亡相关,促进患者首选的终身护理和潜在的成本节省.
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