Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
BMC Health Serv Res. 2021 Jun 24;21(1):599. doi: 10.1186/s12913-021-06575-1.
An existing hospital avoidance program, the Aged Care Rapid Response Team (ARRT), rapidly delivers geriatric outreach services to acutely unwell or older people with declining health at risk of hospitalisation. The aim of the current study was to explore health professionals' perspectives on the factors impacting ARRT utilisation in the care of acutely unwell residential aged care facility residents.
Semi-structured interviews were conducted with two Geriatricians, two ARRT Clinical Nurse Consultants, an ED-based Clinical Nurse Specialist, and an Extended Care Paramedic. Interview questions elicited views on key factors regarding care decisions and care transitions for acutely unwell residential aged care facility residents. Thematic analysis was undertaken to identify themes and sub-themes from interviews.
Analysis of interviews identified five overarching themes affecting ARRT utilisation in the care of acutely unwell residents: (1) resident care needs; (2) family factors; (3) enabling factors; (4) barriers; and (5) adaptability and responsiveness to the COVID-19 pandemic.
Various factors impact on hospital avoidance program utilisation in the care of acutely unwell older aged care facility residents. This information provides additional context to existing quantitative evaluations of hospital avoidance programs, as well as informing the design of future hospital avoidance programs.
现有的老年护理快速反应团队（ARRT）是一项旨在为病情急剧恶化或健康状况不断恶化、有住院风险的老年人提供老年科外联服务的医院回避项目。本研究旨在探讨卫生专业人员对影响 ARRT 在急性不适的养老院居民护理中使用的因素的看法。
对 2 名老年科医生、2 名 ARRT 临床护士顾问、1 名基于 ED 的临床护士专家和 1 名扩展护理护理人员进行了半结构式访谈。访谈问题引出了关于急性不适养老院居民护理决策和护理过渡的关键因素的意见。采用主题分析方法从访谈中识别主题和子主题。
对访谈的分析确定了影响 ARRT 在急性不适居民护理中使用的五个总体主题：（1）居民护理需求；（2）家庭因素；（3）有利因素；（4）障碍；（5）对 COVID-19 大流行的适应性和响应能力。
各种因素影响医院回避项目在急性不适老年护理院居民护理中的使用。这些信息为现有的医院回避项目的定量评估提供了额外的背景信息，也为未来医院回避项目的设计提供了信息。
