电话咨询期间安全网通信:使用记录咨询的观察研究
Peter Jonathan Edwards1, Barbara Caddick2, Adam Skeen3
1University of Bristol Medical School, Centre for Academic Primary Care, Bristol, United Kingdom peter.edwards@bristol.ac.uk.
概括
在NHS GP电话咨询中,安全网建议是常见的,但不一致地交付,记录和召回. 改善这些安全网建议的方面对于远程护理中的患者安全至关重要.
科学领域:
- 初级医疗保健医学 一级医疗保健医学
- 医疗保健服务研究 医疗服务研究
- 患者安全 患者安全
背景情况:
- 电话咨询在英国的全科医生 (GP) 中越来越普遍,在2024年占英格兰NHS全科医生咨询的三分之一.
- 虽然方便,但远程咨询可能会增加患者和全科医生的诊断不确定性.
- 安全网建议对于减轻临床风险至关重要,在电话咨询中没有得到广泛的研究.
研究的目的:
- 评估GP电话咨询期间的安全网建议的沟通,文档和患者召回情况.
- 确定影响远程初级保健机构提供安全网建议的因素.
主要方法:
- 一项观察性研究分析了英格兰西南部7家GP实践的96次记录的电话咨询 (2023-24).
- 咨询使用经过验证的安全网编码工具进行了编码.
- 通过咨询后的问卷来评估患者的咨询回忆,回归模型确定了与咨询提供相关的因素.
主要成果:
- 在60.4%的咨询中提供了安全网建议,解决了43.4%的患者问题.
- 咨询主要由全科医生发起 (95.7%) 并在治疗规划期间提供 (66.7%).
- 文件记录发生在64.2%的病例中,有可用的笔记,患者回忆建议约为三分之二.
结论:
- 在全科医生电话咨询中经常提供安全网建议,但其交付,文档和患者召回不一致.
- 年轻的全科医生 (<45岁) 更有可能提供安全网的建议.
- 需要提高一致性,文档和书面建议的使用,以提高患者在远程医疗保健中的理解和安全.
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