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如何提高在 24 小时内出院的成年患者的急救护理水平?急诊科急性护理计划(ACE 研究):一项参与式设计研究的方案。

How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study.

机构信息

Department of Emergency Medicine, Odense Universitetshospital, Odense, Denmark

Clinical Institute, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark.

出版信息

BMJ Open. 2020 Dec 22;10(12):e041743. doi: 10.1136/bmjopen-2020-041743.

Abstract

INTRODUCTION

The development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient's and family's ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.

METHODS AND ANALYSIS

The study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.

ETHICS AND DISSEMINATION

The study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000-111). Findings will be published in suitable international journals and disseminated through conferences.

摘要

简介

急性症状的发展或疾病的变化导致了恐惧和脆弱感,需要得到卫生专业人员的支持。因此,急诊部(ED)的急性内科和外科护理非常重要,因为它影响着患者和家属在出院后管理日常生活的信心。由于人口结构变化和注重门诊护理,短时间(<24 小时)住院的人数有所增加。明确的出院信息并纳入治疗决策可以提高患者和家属理解和管理出院后健康需求的能力,降低再入院的风险。本研究旨在确定 ED 护理的需求,并制定解决方案,以改善 24 小时内出院的患者的结局。

方法和分析

该研究包括参与式设计(PD)的三个阶段。第 1 阶段旨在了解和确定患者和家属在入院 24 小时内出院时的需求。将在两个不同的 ED 中进行定性观察性研究,随后对患者及其家属进行 20 次联合访谈。与医疗保健专业人员进行 4 次焦点小组访谈,以了解短期途径。第 1 阶段的结果将为第 2 阶段提供信息,第 2 阶段旨在开发一种改善患者结局的解决方案。设计加开发解决方案将安排三次与利益相关者相关的研讨会,并制定具体的成果。该解决方案将在第 3 阶段实施和测试。在这里,我们报告第 1 阶段和第 2 阶段的研究方案。

伦理和传播

该研究已在丹麦数据保护局(19/22672)注册。该项目已获得南丹麦地区卫生研究伦理委员会(S-20192000-111)的批准。研究结果将发表在合适的国际期刊上,并通过会议传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14b9/7757437/20cb8cfe02d4/bmjopen-2020-041743f01.jpg

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