Department of Community Health Systems, University of California, San Francisco, CA, USA.
Department of Physiological Nursing, University of California, San Francisco, CA, USA.
Clin Nurs Res. 2020 Mar;29(3):157-168. doi: 10.1177/1054773819835015. Epub 2019 Apr 21.
In this descriptive, qualitative study, we conducted eight focus groups with diverse informal and formal caregivers to explore their experiences/challenges with nursing home (NH) to emergency department (ED) transfers and whether telehealth might be able to mitigate some of those concerns. Interviews were transcribed and analyzed using a grounded theory approach. Transfers were commonly viewed as being influenced by a perceived lack of trust in NH care/capabilities and driven by four main factors: questioning the quality of NH nurses' assessments, perceptions that physicians were absent from the NH, misunderstandings of the capabilities of NHs and EDs, and perceptions that responses to medical needs were inadequate. Participants believed technology could provide "the power of the visual" permitting virtual assessment for the off-site physician, validation of nursing assessment, "real time" assurance to residents and families, better goals of care discussions with multiple parties in different locations, and family ability to say goodbye.
在这项描述性、定性研究中，我们与不同的非正式和正式护理人员进行了八次焦点小组讨论，以探讨他们在养老院（NH）到急诊部（ED）的转院过程中的经验/挑战，以及远程医疗是否能够缓解其中的一些担忧。访谈采用扎根理论方法进行转录和分析。转移通常被认为受到对 NH 护理/能力缺乏信任的影响，并受到四个主要因素的驱动：对 NH 护士评估质量的质疑、认为医生不在 NH 的看法、对 NH 和 ED 能力的误解，以及对医疗需求反应不足的看法。参与者认为，技术可以提供“视觉的力量”，允许现场外医生进行虚拟评估，验证护理评估，向居民和家属提供“实时”保证，在不同地点与多方更好地讨论护理目标，以及家属能够说再见。
