评估老年医主导的急诊室护理模式的实施:使用实施研究综合框架进行定性研究
Celene Y L Yap1,2,3, Cilla J Haywood4,5, Sanka Amadoru6,7,8,9
1Department of Critical Care, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 157-159 Barry Street, Victoria, 3010, Australia. yen.yap@unimelb.edu.au.
European geriatric medicine
|December 24, 2025
概括
在急诊室 (ED) 实施老年医主导的护理模式 (GEDI) 需要解决临床医生的意识,转诊流程和服务能力,以获得成功的采用和可持续性. 这种方法通过将专业的老年病专业知识整合到常规ED工作流程中,提高了对老年人的照顾.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 老年人经常以复杂的需求出现在急诊室 (ED).
- 现有的ED模型可能无法充分解决独特的老年人护理要求.
- 老年急诊室创新 (GEDI) 模式旨在将老年专业知识嵌入ED.
研究的目的:
- 检查GEDI模型的采用,工作流集成和可持续性的决定因素.
- 确定影响ED中老年医主导护理模式成功实施的因素.
主要方法:
- 定性研究涉及16次采访和5个重点小组,与31名医疗保健专业人员进行了调查.
- 参与者包括急诊医生,护士,老年医生,药剂师,护理协调员和入院医生.
- 数据分析使用了由实施研究综合框架 (CFIR) 指导的演性内容分析.
主要成果:
- GEDI被评为提供及时,整体的老年医疗评估和促进协作实践.
- 采用障碍包括初级医生之间不一致的意识和可变的人员配置.
- 工作流集成的挑战来自于ED环境和转介标准的变化.
- 持续性受到不明确的转诊范围,过早的转诊和老年医生能力有限的威胁.
结论:
- 由老年科医生领导的ED模型可以集成到工作流程中,具有强大的跨专业合作和可访问的专业专业知识.
- 跨环境的成功实施需要根据环境和组织因素进行本地适应.
- 可持续性的关键考虑因素包括角色明确性,优化推流程,临床医生导向和足够的服务能力.
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