O'Donnell Sinéad M, Carison Anna, Adams Jessica, Long Elliot, Babl Franz E
Emergency Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Emergency Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Emerg Med Australas. 2020 Aug;32(4):556-561. doi: 10.1111/1742-6723.13453. Epub 2020 Feb 5.
Audit and research projects in the ED are important to improve patient care but can be time and resource consuming. We identified and prioritised audit and research topics among multidisciplinary ED staff to fill perceived knowledge gaps, encourage engagement, reduce duplication and facilitate translation of evidence into clinical practice.
A two-stage electronic Delphi survey process was undertaken by senior medical, nursing, education and social work staff at the Royal Children's Hospital, Victoria. Survey 1 collected demographic data and audit and research ideas following a series of open-ended questions. Priority themes were defined as those that had more than four responses. Survey 2 used a 7-point Likert ranking of these themes to generate a departmental audit and research prioritisation list.
72/89 (82%) available senior staff responded to survey 1 and 63/83 (76%) responded to survey 2. Survey 1 yielded 208 audit and 130 research topics. Survey 2 established a prioritised list of 17 audit and 14 research topics. Top audit themes were mental healthcare, patient flow, management of sepsis and delays in ED specialist referrals. Top research priorities were the management of sepsis, mental healthcare, management of patients with autism and the management of severe asthma.
This Delphi study has provided departmental audit and research priorities that are perceived to be of importance across the multidisciplinary ED team. This methodology allows strategic allocation of limited resources and may increase staff engagement.
急诊科的审核与研究项目对于改善患者护理至关重要,但可能耗费时间和资源。我们在急诊科多学科工作人员中确定了审核与研究主题并排出优先顺序,以填补认知上的知识空白,鼓励参与,减少重复,并促进将证据转化为临床实践。
维多利亚州皇家儿童医院的高级医学、护理、教育和社会工作工作人员开展了一个两阶段的电子德尔菲调查过程。调查1在一系列开放式问题之后收集了人口统计学数据以及审核与研究想法。优先主题被定义为那些有超过四个回复的主题。调查2对这些主题采用7点李克特量表排名,以生成部门审核与研究优先顺序清单。
89名可用高级工作人员中有72名(82%)回复了调查1,83名中有63名(76%)回复了调查2。调查1产生了208个审核主题和130个研究主题。调查2确定了一份包含17个审核主题和14个研究主题的优先顺序清单。首要审核主题是精神卫生保健、患者流程、脓毒症管理以及急诊科专科转诊延迟。首要研究优先事项是脓毒症管理、精神卫生保健、自闭症患者管理以及重度哮喘管理。
这项德尔菲研究提供了部门审核与研究优先事项,多学科急诊科团队认为这些事项很重要。这种方法允许对有限资源进行战略分配,并可能提高工作人员的参与度。