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急诊科老年患者护理:来自澳大利亚的健康专业人员视角——安全老年急诊出院项目

Caring for older patients in the emergency department: Health professionals' perspectives from Australia - The Safe Elderly Emergency Discharge project.

作者信息

Lennox Alyse, Braaf Sandra, Smit De Villiers, Cameron Peter, Lowthian Judy A

机构信息

School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.

出版信息

Emerg Med Australas. 2019 Feb;31(1):83-89. doi: 10.1111/1742-6723.13108. Epub 2018 May 24.

Abstract

OBJECTIVE

To explore health professionals' perspectives about caring for community-dwelling older patients in the ED.

METHODS

This exploratory qualitative study was undertaken with emergency nursing, medical and allied health staff from the ED of a large metropolitan public hospital in Melbourne. Nine focus groups (n = 54) and seven interviews were conducted between 2013 and 2014. Data were thematically analysed.

RESULTS

Health professionals described tailoring their approach when caring for older patients, including adopting a specific communication approach (i.e. increased voice volume, slower rate of speech). Caring for older patients was perceived as challenging given the need to balance the expectations of family members to deal with associated complex needs and limited time for transitional care planning in the ED. The environment and equipment were perceived as unsuitable, alongside a lack of geriatric-specific knowledge; contributing to what health professionals described as a poor fit between the ED system and older patients' needs.

CONCLUSION

The growing number of older patients presents numerous challenges for emergency health professionals and necessitates a tailored approach to care. Understanding health professionals' perspectives about caring for older patients can inform strategies that may improve the quality of care. Creating older person-friendly areas, improving transitional care and providing staff with specific education would foster an environment that promotes person-centred care, safety, independence and functional wellbeing.

摘要

目的

探讨卫生专业人员对在急诊科护理社区居住老年患者的看法。

方法

本探索性定性研究针对墨尔本一家大型都市公立医院急诊科的急诊护理、医疗和相关卫生人员开展。在2013年至2014年期间进行了9个焦点小组访谈(n = 54)和7次个人访谈。对数据进行了主题分析。

结果

卫生专业人员描述了在护理老年患者时调整自己的方法,包括采用特定的沟通方式(即提高音量、放慢语速)。鉴于需要平衡家庭成员处理相关复杂需求的期望以及急诊科过渡护理计划的时间有限,护理老年患者被认为具有挑战性。环境和设备被认为不合适,同时缺乏老年病方面的专业知识;这导致卫生专业人员所描述的急诊科系统与老年患者需求之间的不匹配。

结论

老年患者数量的不断增加给急诊卫生专业人员带来了诸多挑战,因此需要采取量身定制的护理方法。了解卫生专业人员对护理老年患者的看法可为可能提高护理质量的策略提供参考。创建对老年人友好的区域、改善过渡护理并为工作人员提供特定教育将营造一个促进以患者为中心的护理、安全、独立和功能健康的环境。

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