Williams Jennifer, Petrov George, Kennedy Una, Halpenny Joanie, Doherty Colin P
Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland.
Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland.
Epilepsy Behav. 2017 Jul;72:72-77. doi: 10.1016/j.yebeh.2017.04.022. Epub 2017 Jun 7.
To identify barriers to implementation of an evidence based integrated care pathway (ICP) for seizure management in the Emergency Department (ED).
A site specific bespoke questionnaire was designed to solicit anonymous responses from all grades of ED medical and nursing staff to a series of questions regarding utility, feasibility, significance and implementation of a locally designed and championed ICP for seizure management and onward referral.
While 95% of respondents agreed that the pathway ensured patients were treated according to best practice, a number of human factors were identified as barriers to use. These fell into three categories 1) environmental 2) pathway design/process and 3) user related issues.
Most respondents understood and endorsed the evidence based utility of the pathway. Barriers to use, however, are broad with interactions involving many complex human factors. Nevertheless, solutions can be relatively easily formulated but departmental-wide effort is required to comprehensively address all issues.
确定急诊科实施基于证据的癫痫发作管理综合护理路径（ICP）的障碍。
设计了一份针对特定地点的定制问卷，以征集急诊科各级医护人员对一系列关于当地设计并倡导的癫痫发作管理及后续转诊ICP的实用性、可行性、重要性和实施情况的问题的匿名答复。
虽然95%的受访者同意该路径可确保患者得到最佳治疗，但一些人为因素被确定为使用障碍。这些因素分为三类：1）环境因素；2）路径设计/流程因素；3）用户相关问题。
大多数受访者理解并认可该路径基于证据的实用性。然而，使用障碍广泛，涉及许多复杂的人为因素之间的相互作用。尽管如此，解决方案相对容易制定，但需要全科室共同努力才能全面解决所有问题。
