McDonnell Ann, Esmonde Lisa, Morgan Richard, Brown Roy, Bray Kate, Parry Gareth, Adam Sheila, Sinclair Ray, Harvey Sheila, Mays Nicholas, Rowan Kathy
Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Campus, Collegiate Crescent, S1 1WB Sheffield, UK.
J Crit Care. 2007 Sep;22(3):212-8. doi: 10.1016/j.jcrc.2007.02.002. Epub 2007 Jul 6.
The aim of this study was to describe the development, introduction, implementation, and current models of critical care outreach services.
We conducted a national postal survey of National Health Service acute care hospitals in England that routinely provide care for level 1 patients (n = 239).
Completed questionnaires were received from 191 (79.9%) hospitals; 139 (72.8%) had a formal critical care outreach service. A third (32.8%, 45/137) of services covered more than one hospital; 33.8% (45/133) of hospitals provided telephone advice 24 hours a day for 7 days per week, but less than 15% of hospitals offered follow-up or direct bedside clinical support on the same basis. There was wide variation in the proportion of hospital wards covered, the size and composition of the team, the aims of the service, and the balance between provision of direct care and advice.
There are still a significant number of National Health Service acute care hospitals in England with no formal critical care outreach service. In addition, critical care outreach is being delivered in many different ways across the country, and thus means different things in different hospitals. The variation may reflect the lack of evidence as to which approaches are likely to be most effective.
本研究旨在描述重症监护外展服务的发展、引入、实施及当前模式。
我们对英格兰国民健康服务体系下的急性病医院进行了全国性邮寄调查，这些医院常规为1级患者提供护理（n = 239）。
共收到191家（79.9%）医院填写完整的问卷；其中139家（72.8%）设有正式的重症监护外展服务。三分之一（32.8%，45/137）的服务覆盖多家医院；33.8%（45/133）的医院每周7天、每天24小时提供电话咨询服务，但不到15%的医院能在相同基础上提供随访或直接床边临床支持。在所覆盖的医院病房比例、团队规模和组成、服务目标以及直接护理与咨询的平衡方面存在很大差异。
英格兰仍有相当数量的国民健康服务体系急性病医院没有正式的重症监护外展服务。此外，重症监护外展服务在全国以多种不同方式提供，因此在不同医院有不同含义。这种差异可能反映出缺乏关于哪种方法可能最有效的证据。
