在农村环境中实施药剂师主导的COPD CARE包的障碍:定性评估
Edward Christopher Portillo1,2, Martha Maurer3, Steven Do3
1University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin, USA edward.portillo@wisc.edu.
农村医疗保健提供者在实施慢性阻塞性肺病 (COPD) 护理包方面面临重大障碍,包括人员短缺和工作量需求. 解决这些挑战对于改善农村患者的治疗结果至关重要.
科学领域:
- 医疗保健管理的管理
- 农村卫生 农村卫生
- 呼吸系统医学 呼吸系统医学
背景情况:
- 农村人口因呼吸道疾病的死亡率较高,原因是获得护理的机会有限.
- 实施标准化护理包对于管理COPD等慢性疾病至关重要.
研究的目的:
- 确定阻碍在美国退伍军人事务部 (VA) 医疗中心农村地区实施慢性阻塞性肺病 (COPD) 管理护理包的障碍.
- 了解临床医生对实施过程中遇到的挑战的看法.
主要方法:
- 评估了13个州的17个农村VA医疗中心.
- 参与的临床医生包括药房负责人,药剂师,护士护理经理和药房技术人员.
- 利用患者安全系统工程倡议 (SEIPS) 2.0模型对已识别的障碍进行分类.
主要成果:
- 关键障碍包括有限的员工可用性,分散的护理和技术挑战.
- 对药剂师时间的竞争要求和临床医生对管理新疾病状态的担忧也很重要.
- 有限的转介机会进一步使实施复杂化.
结论:
- 人员短缺和繁重的工作负载限制了农村临床医生采用新实践模式和任务的能力.
- 利用跨专业关系和解决技术限制是临床医生用来克服障碍的策略.
- 这些发现有助于更好地了解农村医疗保健机构对护理包的实施障碍.
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