University of Alberta, Edmonton, Canada.
Alberta Health Services, Edmonton, Canada.
J Aging Health. 2020 Mar;32(3-4):119-133. doi: 10.1177/0898264318808908. Epub 2018 Nov 15.
For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. We aimed to describe characteristics of residents transferred, factors related to decisions during transfer, care received in emergency medical services (EMS), ED settings, outcomes on return to LTC, and times of transfer segments along the transition. We prospectively followed 637 transitions to an ED in British Columbia and Alberta, Canada, over a 12-month period. Data were captured through an electronic Transition Tracking Tool and interviews with health care professionals. Common events triggering transfer were falls (26.8%), sudden change in condition (23.5%), and shortness of breath (19.8%). Discrepancies existed between reason for transfer, EMS reported chief complaint, and ED diagnosis. Many transfers resulted in resident return directly to LTC (42.7%). Avoidable transfers may put residents at risk of receiving inappropriate care. Standardized communication strategies to highlight changes in resident condition are warranted.
对于长期护理（LTC）居民，转至急诊部（ED）可能与健康状况不佳有关。我们旨在描述转至 ED 的居民的特征、转至 ED 期间决策的相关因素、在紧急医疗服务（EMS）、ED 环境中接受的护理、返回 LTC 的结果以及过渡期间的转至 ED 各阶段的时间。在 12 个月的时间里，我们前瞻性地跟踪了加拿大不列颠哥伦比亚省和艾伯塔省的 637 次转至 ED 的情况。数据通过电子转至跟踪工具和对医疗保健专业人员的访谈进行收集。常见的转至 ED 事件包括跌倒（26.8%）、病情突然变化（23.5%）和呼吸急促（19.8%）。转至 ED 的原因、EMS 报告的主要投诉和 ED 诊断之间存在差异。许多转至 ED 的居民直接返回 LTC（42.7%）。可避免的转至 ED 可能使居民面临接受不适当护理的风险。有必要制定标准化的沟通策略，以突出居民病情的变化。
