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为澳大利亚农村地区提供循证中风服务面临的挑战。

Challenges of delivering evidence-based stroke services for rural areas in Australia.

作者信息

Prior Sarah Jane, Reeves Nicole S, Campbell Steven J

机构信息

College of Health and Medicine, School of Medicine, University of Tasmania, Burnie, TAS, Australia.

College of Health and Medicine, School of Health Sciences, University of Tasmania, Newnham, TAS, Australia.

出版信息

Aust J Rural Health. 2020 Feb;28(1):15-21. doi: 10.1111/ajr.12579. Epub 2020 Jan 28.

Abstract

OBJECTIVE

The aim of this paper was to use current stroke care guidelines to identify and discuss current stroke care challenges in rural Australian health care and potential solutions for delivery of evidence-based practice.

DESIGN AND SETTING

A review of national guidelines since 2002 for organised stroke care was undertaken to determine best practice for delivering primary stroke care. We then employed a narrative literature review strategy looking at relevant articles, based on keywords, outlining current stroke service availability in Australia, highlighting the challenges of implementing evidence-based stroke care in rural areas in Australia based on the current guidelines.

RESULTS

Delivery of evidence-based stroke care in rural Australia is fraught with challenges. Although national best-practice guidelines for stroke care are well established, the recommendations made in these guidelines do not always reflect the resource availability in rural Australia. Redesigning processes and utilising available resources, such as telemedicine or local clinical pathways, can achieve an evidence-based standard; however, ultimately better resourcing of these areas is required.

CONCLUSION

Evidence-based stroke care, aligned with current national standards is the key to providing adequate stroke services in rural Australia. Improved health service resourcing and better utilisation of currently available resources are options for achieving elements of evidence-based stroke care.

IMPLICATIONS FOR PUBLIC HEALTH

Availability of adequate services for stroke patients directly impacts public health as it determines health outcomes for these patients. Indirect implications for public health include the effects on health professionals and the general public.

摘要

目的

本文旨在运用当前的卒中护理指南,识别并探讨澳大利亚农村医疗保健中当前的卒中护理挑战以及实施循证实践的潜在解决方案。

设计与背景

对2002年以来有关有组织的卒中护理的国家指南进行了回顾,以确定提供初级卒中护理的最佳实践。然后,我们采用叙述性文献回顾策略,根据关键词查找相关文章,概述澳大利亚当前的卒中服务可及性,突出基于当前指南在澳大利亚农村地区实施循证卒中护理的挑战。

结果

在澳大利亚农村地区提供循证卒中护理充满挑战。尽管卒中护理的国家最佳实践指南已完善确立,但这些指南中的建议并不总是反映澳大利亚农村地区的资源可及情况。重新设计流程并利用现有资源,如远程医疗或当地临床路径,可达到循证标准;然而,最终这些地区需要更好的资源配置。

结论

符合当前国家标准的循证卒中护理是在澳大利亚农村地区提供充足卒中服务的关键。改善卫生服务资源配置以及更好地利用现有资源是实现循证卒中护理要素的选择。

对公共卫生的影响

为卒中患者提供充足服务直接影响公共卫生,因为这决定了这些患者的健康结局。对公共卫生的间接影响包括对卫生专业人员和公众的影响。

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