自我护理指数和急性后期护理出院评分预测成年内科住院患者的出院目的地：一项多中心验证研究方案

Self-Care Index and Post-Acute Care Discharge Score to Predict Discharge Destination of Adult Medical Inpatients: Protocol for a Multicenter Validation Study.

作者信息

Conca Antoinette, Koch Daniel, Regez Katharina, Kutz Alexander, Bächli Ciril, Haubitz Sebastian, Schuetz Philipp, Mueller Beat, Spirig Rebecca, Petry Heidi

机构信息

Department of Nursing Science, University Witten/Herdecke, Witten, Germany.

Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.

出版信息

JMIR Res Protoc. 2021 Jan 14;10(1):e21447. doi: 10.2196/21447.

DOI:10.2196/21447

PMID:33263553

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7843199/

Abstract

BACKGROUND

Delays in patient discharge can not only lead to deterioration, especially among geriatric patients, but also incorporate unnecessary resources at the hospital level. Many of these delays and their negative impact may be preventable by early focused screening to identify patients at risk for transfer to a post-acute care facility. Early interprofessional discharge planning is crucial in order to fit the appropriate individual discharge destination. While prediction of discharge to a post-acute care facility using post-acute care discharge score, the self-care index, and a combination of both has been shown in a single-center pilot study, an external validation is still missing.

OBJECTIVE

This paper outlines the study protocol and methodology currently being used to replicate the previous pilot findings and determine whether the post-acute care discharge score, the self-care index, or the combination of both can reliably identify patients requiring transfer to post-acute care facilities.

METHODS

This study will use prospective data involving all phases of the quasi-experimental study "In-HospiTOOL" conducted at 7 Swiss hospitals in urban and rural areas. During an 18-month period, consecutive adult medical patients admitted to the hospitals through the emergency department will be included. We aim to include 6000 patients based on sample size calculation. These data will enable a prospective external validation of the prediction instruments.

RESULTS

We expect to gain more insight into the predictive capability of the above-mentioned prediction instruments. This approach will allow us to get important information about the generalizability of the three different models. The study was approved by the institutional review board on November 21, 2016, and funded in May 2020. Expected results are planned to be published in spring 2021.

CONCLUSIONS

This study will provide evidence on prognostic properties, comparative performance, reliability of scoring, and suitability of the instruments for the screening purpose in order to be able to recommend application in clinical practice.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/21447.

摘要

背景

患者出院延迟不仅会导致病情恶化，尤其是老年患者，还会在医院层面占用不必要的资源。通过早期重点筛查以识别有转至急性后护理机构风险的患者，许多此类延迟及其负面影响可能是可预防的。早期跨专业出院计划对于确定合适的个体出院目的地至关重要。虽然在一项单中心试点研究中已显示使用急性后护理出院评分、自我护理指数以及两者结合来预测转至急性后护理机构的情况，但仍缺少外部验证。