重症监护病房实施远程伦理咨询的技术考量
Technical Considerations for Implementation of Tele-Ethics Consultation in the Intensive Care Unit.
作者信息
Johnson Laura S, Brenner David M, Sederstrom Nneka O
机构信息
Georgetown University School of Medicine, Washington, District of Columbia USA; Section of Burns and Trauma, Medstar Washington Hospital Center, Washington, District of Columbia USA. Laura.S.Johnson @medstar.net.
Telehealth Initiatives, MedStar Institute for Innovation, Washington, District of Columnbia USA.
出版信息
J Clin Ethics. 2018 Winter;29(4):285-290.
BACKGROUND
Robust ethics consultation services cannot be sustained by all hospitals; consultative service from a high-volume center via teleconferencing is an attractive alternative. This pilot study was conceived to explore the feasibility and understand the practical implications of offering such a service.
METHODS
High-definition videoconferencing was used to provide real-time interaction between the rounding clinicians and a remote clinical ethicist. Data collection included: (1) evaluation of the hardware and software required for teleconferencing, and (2) comparison of ethics trigger counts between the remote and on-site ethicist during rounds.
RESULTS
Issues with audio represented the majority of technical problems. Once technical difficulties were addressed, the on-site ethicist's count of "triggers" was not statistically different from the count of the remote ethicist.
CONCLUSION
Remote clinical ethics rounding is feasible when the equipment is optimized. Remote ethicists can identify similar numbers of "triggers" for possible ethical issues when compared to on-site ethicist numbers.
背景
并非所有医院都能维持强大的伦理咨询服务；通过电话会议从高工作量中心提供咨询服务是一个有吸引力的选择。开展这项试点研究旨在探索提供此类服务的可行性并了解其实际影响。
方法
使用高清视频会议在查房临床医生与远程临床伦理学家之间提供实时互动。数据收集包括：（1）对电话会议所需硬件和软件的评估，以及（2）查房期间远程伦理学家与现场伦理学家之间伦理触发因素数量的比较。
结果
音频问题是大多数技术问题。一旦解决了技术难题，则现场伦理学家的“触发因素”计数与远程伦理学家的计数在统计学上无差异。
结论
当设备得到优化时，远程临床伦理查房是可行的。与现场伦理学家相比，远程伦理学家能够识别出数量相近的可能存在伦理问题的“触发因素”。
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