Buick T A, Hamilton D, Weatherdon G, O'Shea C I, McAlpine G
Trainee, NHS Lothian, UK.
Trainee, Royal Edinburgh Hospital, UK.
BJPsych Bull. 2018 Oct;42(5):211-216. doi: 10.1192/bjb.2018.41.
Psychiatric in-patients are often transferred to an emergency department for care of minor wounds, incurring significant distress to the patient and cost to the service.
To improve superficial wound management in psychiatric in-patients and reduce transfers to the emergency department.
Thirty-four trainees attended two peer-led suturing and wound management teaching sessions, and a suturing kit box was compiled and stored at the Royal Edinburgh Hospital. Teaching was evaluated using Kirkpatrick's model, and patient transfer numbers were acquired by reviewing in-patient Datix reports and emergency department case notes for 6 months before and after teaching.
The proportion of patients transferred to the emergency department decreased significantly from 90% 6 months before the workshop to 30% 6 months after ( < 0.05). Trainees engaged positively and there was a significant increase in self-confidence rating following the workshop ( < 0.05). The estimated cost saving per transfer was £183.76.
The combination of a peer-led workshop and on-site suturing kit box was effective in reducing transfers to the emergency department and provided a substantial cost saving.
None.
精神科住院患者常因轻伤被转至急诊科治疗,这给患者带来极大痛苦,也给医疗服务带来高昂成本。
改善精神科住院患者的浅表伤口处理,减少转至急诊科的情况。
34名学员参加了两次由同行主导的缝合及伤口处理教学课程,爱丁堡皇家医院编制并存放了一个缝合套件箱。教学采用柯克帕特里克模型进行评估,通过查阅教学前后6个月的住院患者达蒂克斯报告及急诊科病例记录获取患者转院人数。
转至急诊科的患者比例从工作坊前6个月的90%显著降至工作坊后6个月的30%(P<0.05)。学员参与积极性高,工作坊后自信心评分显著提高(P<0.05)。每次转院估计节省成本183.76英镑。
由同行主导的工作坊与现场缝合套件箱相结合,有效减少了转至急诊科的情况,并节省了大量成本。
无。