急诊科中包括卫生和社会护理专业人员在内的跨学科团队进行早期评估和干预的有效性：一项系统评价方案

Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review.

作者信息

Cassarino Marica, Robinson Katie, Quinn Rosie, Naddy Breda, O'Regan Andrew, Ryan Damien, Boland Fiona, Ward Marie E, McNamara Rosa, McCarthy Gerard, Galvin Rose

机构信息

School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.

Emergency Department, Our Lady of Lourdes Hospital Drogheda, Drogheda, Ireland.

出版信息

BMJ Open. 2018 Jul 16;8(7):e023464. doi: 10.1136/bmjopen-2018-023464.

DOI:10.1136/bmjopen-2018-023464

PMID:30012796

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6082452/

Abstract

INTRODUCTION

Finding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.

METHODS AND ANALYSIS

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before-after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.

ETHICS AND DISSEMINATION

Ethical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.

TRIAL REGISTRATION NUMBER

CRD42018091794.

摘要

引言

鉴于急诊科就诊人数不断增加，寻找具有成本效益的策略以改善急诊科的患者护理变得愈发迫切。有令人鼓舞的证据表明，包括健康和社会护理专业人员（HSCPs）在内的跨学科团队可在各种医疗环境中提升患者护理质量。然而，迄今为止，尚无关于此类团队在急诊科进行早期评估和/或干预效果的系统评价。本系统评价旨在探讨包括HSCPs在内的跨学科团队在急诊科进行的早期评估和/或干预对护理质量、安全性和成本效益的影响，并确定HSCPs提供的评估和/或干预内容。

方法与分析

我们将使用系统评价和Meta分析的首选报告项目标准化指南，对随机对照试验（RCTs）、非随机对照试验、前后对照研究、中断时间序列研究和重复测量研究进行系统评价，这些研究报告了包括HSCPs在内的跨学科团队对18岁及以上成年人在急诊科进行早期评估和/或干预的影响。检索将从创刊至2018年3月在护理及相关健康文献累积索引、Embase、Cochrane图书馆和MEDLINE中进行。我们还将手工检索相关研究的参考文献列表。经过两步筛选过程，两名独立评审员将提取关于人群类型、干预措施、对照、结局和研究设计的数据。将使用Cochrane偏倚风险工具评估研究质量。研究结果将以叙述性总结的形式进行综合，并在适当情况下进行Meta分析。