通过改善初级保健服务能否避免老年护理机构的患者转至急诊科？来自定性访谈的数据。
Can transfers from residential aged care facilities to the emergency department be avoided through improved primary care services? Data from qualitative interviews.
作者信息
Arendts Glenn, Reibel Tracy, Codde Jim, Frankel Jackie
机构信息
Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research and University of Western Australia, Perth, Western Australia, Australia.
出版信息
Australas J Ageing. 2010 Jun;29(2):61-5. doi: 10.1111/j.1741-6612.2009.00415.x.
AIM
To explore the factors that influence the transfer of patients from residential aged care facilities (RACF) to hospital emergency departments (ED), and describe features of improved primary care in RACF that could result in reduced transfer.
METHODS
a. Three focus groups conducted with family and carers of RACF residents, along with RACF, ED and general practice staff. b. Semistructured one-on-one interviews with nine residents of RACF.
RESULTS
Five main themes emerged--staffing and skill mix in RACF, treatment options in RACF, end of life decision-making, communication and bureaucratic requirements. Analysis of the semistructured interviews demonstrated parallel concerns with many of the focus groups indicators. There was a strong but not universal preference among residents to minimise RACF to ED transfer.
CONCLUSIONS
The transfer of residents from RACF to ED is influenced by multiple interrelated factors, and strategies to reduce transfer should address these.
目的
探讨影响老年护理院（RACF）患者转至医院急诊科（ED）的因素，并描述RACF中可减少转院的改善初级护理的特征。
方法
a. 与RACF居民的家属及护理人员、RACF工作人员、急诊科工作人员和全科医生进行了三个焦点小组讨论。b. 对九名RACF居民进行半结构化一对一访谈。
结果
出现了五个主要主题——RACF的人员配备和技能组合、RACF的治疗选择、临终决策、沟通和官僚要求。对半结构化访谈的分析表明，许多焦点小组指标存在类似的问题。居民们强烈但并非普遍倾向于尽量减少从RACF转至ED。
结论
RACF居民转至ED受多种相互关联的因素影响，减少转院的策略应针对这些因素。
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