Emergency Medicine Research Unit, University of Southern Denmark, Kløvervænget 25, 5000 Odense, Denmark.
Migrant Health Clinic and Department of Geriatric Medicine, Odense University Hospital, Kløvervænget 23, 5000 Odense, Denmark.
Age Ageing. 2022 Aug 2;51(8). doi: 10.1093/ageing/afac170.
hospital admissions of residents from nursing homes often lead to delirium, infections, mortality and reduced functional capacity. We initiated a new service, 'emergency department-based acute care service', maintained by consultants from an emergency department (ED) moving emergency care from the hospitals into nursing homes.
this study explored healthcare professionals' experiences with this service.
qualitative semi-structured focus group discussions.
INTERVENTION/SETTING: the new service provides acute on-site evaluation and treatment to nursing home residents following calls to the emergency dispatch centre.
we conducted focus groups with general practitioners, prehospital personnel, municipal acute care nurses, ED staff and nursing home staff. The analysis was performed using the iterative and explorative approach, 'systematic text condensation'.
the participants considered the service as a meaningful and appropriate alternative to hospital admission, as the treatment can be tailored to meet the residents' wishes and daily capabilities. This was experienced to promote dignity for the residents by reducing unnecessary transfers to the ED and the residents could remain in familiar surroundings with staff who knew their habitual behaviour and history. The nursing home staff contributed valuable information to the ED consultants' decision-making. The service made it possible to base the decision-making on complete patient pictures, as the ED consultants had the time to get to understand the residents.
acute care at nursing homes provides an alternative to routine admissions to hospitals and enables healthcare professionals to provide more dignity in the care of nursing home residents.
养老院居民的住院常常导致谵妄、感染、死亡和功能能力下降。我们启动了一项新服务，即“基于急诊科的急性护理服务”，由急诊科的顾问来维持，将急诊护理从医院转移到养老院。
本研究探讨了医疗保健专业人员对这项服务的体验。
定性半结构式焦点小组讨论。
干预/设置：新服务为养老院居民在拨打急救调度中心电话后提供现场急性评估和治疗。
我们对全科医生、院前人员、市急性护理护士、ED 工作人员和养老院工作人员进行了焦点小组讨论。分析采用迭代和探索性方法“系统文本凝结”进行。
参与者认为该服务是医院入院的一种有意义且合适的替代方案，因为治疗可以根据居民的意愿和日常能力进行调整。这被认为通过减少对 ED 的不必要转移来提高居民的尊严，并且居民可以在熟悉的环境中与了解他们习惯行为和病史的工作人员一起生活。养老院工作人员为 ED 顾问的决策提供了有价值的信息。该服务使 ED 顾问能够基于完整的患者信息做出决策，因为他们有时间了解居民的情况。
养老院的急性护理为常规住院提供了替代方案，并使医疗保健专业人员能够在护理养老院居民时提供更多的尊严。
