建立基于急诊室的护理情节定义的标准:修改后的Delphi研究
Keith E Kocher1,2,3, Aimee D Myers4, Tracy H Urech5
1VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA kkocher@umich.edu.
为胸痛,心力衰竭,肺炎,慢性肺炎和自杀倾向的紧急诊所 (ED) 开发了标准化的护理定义. 这些定义有助于评估ED护理成本和结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 紧急医疗 紧急医疗
- 卫生经济学 卫生经济学
背景情况:
- 对于急诊室 (ED) 护理的传统分析往往忽略了下游成本和并发症.
- 为了全面评估ED护理情节,需要标准化定义.
研究的目的:
- 为五种常见的,高成本的疾病在ED治疗中制定标准化的护理定义.
- 为了能够更好地评估ED护理的提供,下游成本和结果.
主要方法:
- 一个两轮修改后的Delphi小组研究,涉及11名多学科专家.
- 文献综述,证据综合和结构化调查与匿名反.
- 如果标准达到预定义的有效度值而没有小组意见分歧,则被保留.
主要成果:
- 建立了基于ED的胸痛,充血性心力衰竭 (CHF),肺炎,慢性阻塞性肺病 (COPD) 和自杀倾向的护理情节的操作定义.
- 德尔菲过程改进了许多候选标准,特别是对于事件排除.
- 专题分析揭示了事件排除标准和风险调整异质性之间的权衡.
结论:
- 已经成功地建立了五个关键ED条件的标准化护理定义.
- 这些定义可以帮助医疗管理人员,政策制定者和研究人员.
- 这些定义支持评估ED护理的变化以及相关的下游成本和结果.
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