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急诊科知识转化中的公共卫生考量

Public health considerations in knowledge translation in the emergency department.

作者信息

Bernstein Steven L, Bernstein Edward, Boudreaux Edwin D, Babcock-Irvin Charlene, Mello Michael J, Kapur Atul K, Becker Bruce M, Sattin Richard, Cohen Victor, D'Onofrio Gail

机构信息

Department of Emergency Medicine, Albert Einstein College of Medicine, Bronx, NY, UAS.

出版信息

Acad Emerg Med. 2007 Nov;14(11):1036-41. doi: 10.1197/j.aem.2007.06.012. Epub 2007 Aug 15.

Abstract

Effective preventive and screening interventions have not been widely adopted in emergency departments (EDs). Barriers to knowledge translation of these initiatives include lack of knowledge of current evidence, perceived lack of efficacy, and resource availability. To address this challenge, the Academic Emergency Medicine 2007 Consensus Conference, "Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake," convened a public health focus group. The question this group addressed was "What are the unique contextual elements that need to be addressed to bring proven preventive and other public health initiatives into the ED setting?" Public health experts communicated via the Internet beforehand and at a breakout session during the conference to reach consensus on this topic, using published evidence and expert opinion. Recommendations include 1) to integrate proven public health interventions into the emergency medicine core curriculum, 2) to configure clinical information systems to facilitate public health interventions, and 3) to use ancillary ED personnel to enhance delivery of public health interventions and to obtain successful funding for these initiatives. Because additional research in this area is needed, a research agenda for this important topic was also developed. The ED provides medical care to a unique population, many with increased needs for preventive care. Because these individuals may have limited access to screening and preventive interventions, wider adoption of these initiatives may improve the health of this vulnerable population.

摘要

有效的预防和筛查干预措施在急诊科(EDs)尚未得到广泛采用。这些举措在知识转化方面存在障碍,包括对当前证据缺乏了解、认为缺乏疗效以及资源可用性问题。为应对这一挑战,2007年学术急诊医学共识会议“急诊医学中的知识转化:建立证据应用的研究议程和指南地图”召集了一个公共卫生焦点小组。该小组探讨的问题是“为将已证实的预防及其他公共卫生举措引入急诊环境,需要解决哪些独特的背景因素?”公共卫生专家会前通过互联网交流,并在会议期间的分组讨论会上就该主题达成共识,依据已发表的证据和专家意见提出建议,包括:1)将已证实的公共卫生干预措施纳入急诊医学核心课程;2)配置临床信息系统以促进公共卫生干预措施的实施;3)利用急诊科辅助人员加强公共卫生干预措施的实施,并为这些举措成功获取资金。鉴于该领域需要更多研究,还制定了关于这一重要主题的研究议程。急诊科为特定人群提供医疗服务,其中许多人对预防保健的需求增加。由于这些人获得筛查和预防干预措施的机会可能有限,更广泛地采用这些举措可能会改善这一弱势群体的健康状况。

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