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荷兰2021 - 2026年院前急救医疗服务的更新国家研究议程:一项德尔菲研究。

The updated national research agenda 2021-2026 for prehospital emergency medical services in the Netherlands: a Delphi study.

作者信息

Vloet Lilian C M, Hesselink Gijs, Berben Sivera A A, Hoogeveen Margreet, Rood Paul J T, Ebben Remco H A

机构信息

School of Health Studies, Research Department of Emergency and Critical Care, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.

Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Scand J Trauma Resusc Emerg Med. 2021 Nov 20;29(1):162. doi: 10.1186/s13049-021-00971-6.

Abstract

BACKGROUND

In 2015, a national research agenda was established for Dutch prehospital EMS to underpin the evidence base of care delivery and inform policymakers and funders. The continuously increasing demand for ambulance care and the reorientation towards the role of EMS in recent years may have changed research priorities. Therefore, this study aimed to update the Dutch national EMS research agenda.

METHODS

A three-round online Delphi survey was used to explore and discuss different viewpoints and to reach consensus on research priorities (i.e., themes and special interest groups, e.g. patient types who require specific research attention). A multidisciplinary expert panel (n = 62) was recruited in the field of prehospital EMS and delegates of relevant professional organizations and stakeholders participated. In round one, fifty-nine research themes and six special interest groups (derived from several resources) were rated on importance on a 5-point scale by the panel members. In round two, the panel selected their priority themes and special interest groups (yes/no), and those with a positive difference score were further assessed in round three. In this final round, appropriateness of the remaining themes and agreement within the panel was taken into account, following the RAND/UCLA appropriateness method, which resulted in the final list of research priorities.

RESULTS

The survey response per round varied between 94 and 100 percent. In round one, a reduction from 59 to 25 themes and the selection of three special interest groups was realized. Round two resulted in the prioritization of six themes and one special interest group ('Vulnerable elderly'). Round three showed an adequate level of agreement regarding all six themes: 'Registration and (digital) exchange of patient data in the chain of emergency care'; 'Mobile care consultation/Non conveyance'; 'Care coordination'; 'Cooperation with professional partners within the care domain'; 'Care differentiation' and 'Triage and urgency classification'.

CONCLUSIONS

The updated Dutch national EMS research agenda builds further on the previous version and introduces new EMS research priorities that correspond with the future challenges prehospital EMS care is faced with. This agenda will guide researchers, policymakers and funding bodies in prioritizing future research projects.

摘要

背景

2015年,荷兰制定了一项针对院前急救医疗服务(EMS)的国家研究议程,以巩固护理服务的证据基础,并为政策制定者和资助者提供信息。近年来,对救护车护理的需求持续增长,以及急救医疗服务角色的重新定位,可能已经改变了研究重点。因此,本研究旨在更新荷兰国家急救医疗服务研究议程。

方法

采用三轮在线德尔菲调查,以探索和讨论不同观点,并就研究重点(即主题和特殊利益群体,例如需要特别研究关注的患者类型)达成共识。招募了一个院前急救医疗服务领域的多学科专家小组(n = 62),相关专业组织和利益相关者的代表也参与其中。在第一轮中,专家小组成员对59个研究主题和6个特殊利益群体(源自多种资源)的重要性进行5分制评分。在第二轮中,专家小组选择他们的优先主题和特殊利益群体(是/否),得分有正向差异的主题和群体在第三轮中进一步评估。在最后一轮中,按照兰德/加州大学洛杉矶分校的适当性方法,考虑了其余主题的适当性以及专家小组内部的一致性,从而得出最终的研究重点清单。

结果

每轮调查的回复率在94%至100%之间。在第一轮中,主题从59个减少到25个,并选出了3个特殊利益群体。第二轮确定了6个主题和1个特殊利益群体(“弱势老年人”)的优先顺序。第三轮表明,对于所有6个主题都有足够的一致性:“急诊护理链中患者数据的登记和(数字)交换”;“移动护理咨询/不转运”;“护理协调”;“与护理领域内专业合作伙伴的合作”;“护理差异化”以及“分诊和紧急程度分类”。

结论

更新后的荷兰国家急救医疗服务研究议程在先前版本的基础上进一步发展,并引入了与院前急救医疗服务未来面临的挑战相对应的新研究重点。该议程将指导研究人员、政策制定者和资助机构对未来的研究项目进行优先排序。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19cc/8605575/3d0ea6b3038d/13049_2021_971_Fig1_HTML.jpg

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