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院前人员体温监测障碍:采用改良名义群体技术的定性研究。

Barriers to body temperature monitoring among prehospital personnel: a qualitative study using the modified nominal group technique.

机构信息

Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway

Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway.

出版信息

BMJ Open. 2022 Jun 22;12(6):e058910. doi: 10.1136/bmjopen-2021-058910.

Abstract

OBJECTIVES

To identify and explore barriers that healthcare professionals working as prehospital care (PHC) providers at the University Hospital of North Norway experience with temperature monitoring and discover solutions to these problems.

STUDY DESIGN

Qualitative study using the modified nominal group technique.

MATERIALS AND METHODS

14 experienced healthcare professionals working in air and ground emergency medical services were invited to the study. Initially, each participant was asked to suggest through email topics of importance regarding barriers to prehospital thermometry. Afterwards, they received a list of all disparate topics and were asked to individually rank them by importance. The top-ranked topics were discussed in a consensus meeting. The meeting was audio-recorded and a transcript was written and then analysed through an inductive thematic analysis.

RESULTS

13 participants accepted the invitation. 63 suggestions were reduced to 24 disparate topics after removal of duplicates. Twelve highly ranked topics were discussed during the consensus meeting. Thematic analysis revealed 47 codes that were grouped together into six overarching themes, of which four described challenges to monitoring and two described potential solutions: equipment dissatisfaction, little focus on patient temperature, fear of iatrogenic complications, thermometry subordinated, more focus on temperature and simplification of thermometry.

CONCLUSION

To increase the frequency of temperature measurement on correct indication, we suggest introducing PHC protocols that specify patients and conditions where an accurate temperature measurement should have high priority. Furthermore, there is a profound need for more suitable techniques for temperature monitoring in the prehospital setting.

摘要

目的

确定并探讨在挪威北大学医院从事院前医疗(PHC)服务的医护人员在体温监测方面所面临的障碍,并寻找解决这些问题的方法。

研究设计

采用改良名义群体技术的定性研究。

材料和方法

邀请了 14 名在航空和地面急诊医疗服务中经验丰富的医护人员参加这项研究。首先,每个参与者通过电子邮件被要求提出与院前测温障碍相关的重要主题。之后,他们收到了一份所有不同主题的清单,并被要求按重要性对其进行单独排序。排名最高的主题在共识会议上进行了讨论。会议进行了录音,并撰写了一份文字记录,然后通过归纳主题分析进行了分析。

结果

13 名参与者接受了邀请。删除重复项后,63 条建议减少到 24 条不同的主题。在共识会议上讨论了 12 个高度优先的主题。主题分析显示出 47 个代码,这些代码被分为六个总体主题,其中四个主题描述了监测挑战,两个主题描述了潜在的解决方案:设备不满意、对患者体温关注较少、担心医源性并发症、测温被置于次要地位、更关注体温和简化测温。

结论

为了增加在正确指征下测量体温的频率,我们建议引入 PHC 方案,明确规定哪些患者和情况下应高度优先进行准确的体温测量。此外,在院前环境中,非常需要更适合的体温监测技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41c7/9226913/661f96a11139/bmjopen-2021-058910f01.jpg

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