范围综述文献,以确定在急性护理出院后如何为重大创伤患者提供后续护理。

Scoping review of the literature to ascertain how follow-up care is provided to major trauma patients post discharge from acute care.

机构信息

Trauma Service, Gold Coast University Hospital, Southport, Queensland, Australia

School of Medicine, Griffith University, Southport, Queensland, Australia.

出版信息

BMJ Open. 2022 Sep 8;12(9):e060902. doi: 10.1136/bmjopen-2022-060902.

Abstract

OBJECTIVES

Survival following traumatic injury has increased, requiring ongoing patient follow-up. While longitudinal outcomes of trauma patients are reported, little is known about optimal delivery of follow-up service for this group. The aim of this scoping review was to identify and describe the structure, process and outcomes of postdischarge follow-up services for patients who sustained major trauma.

EVIDENCE REVIEW

This scoping review was conducted by searching CINAHL, MEDLINE and EMBASE databases. Articles were screened by three independent reviewers. The data of selected articles were organised in the categories of the Donabedian quality framework: structure, processes and outcomes.

RESULTS

Twenty-six articles were included after screening by title/abstract then full text against the inclusion/exclusion criteria; 92% (n=24) were from the USA.Follow-up services were provided by designated trauma centres and delivered by a mixture of health disciplines. Delivery of follow-up was multimodal (in person/telehealth). Protocols and guidelines helped to deliver follow-up care for non-physician led services.Ongoing health issues including missed injuries, pain and infection were identified. No standardised criteria were established to determine recipients, the timing or frequency of follow-up was identified. Patients who engaged with follow-up services were more likely to participate in other health services. Patients reported satisfaction with follow-up care.

CONCLUSION

There are wide variations in how follow-up services for major trauma patients are provided. Further evaluation should focus on patient, family and organisational outcomes. Identifying who is most likely to benefit, when and how follow-up care is delivered are important next steps in improving outcomes.

摘要

目的

创伤后患者的生存率提高,需要持续进行患者随访。虽然已经报道了创伤患者的纵向结局,但对于该人群的最佳随访服务提供方式知之甚少。本范围综述的目的是确定和描述为遭受重大创伤的患者提供的出院后随访服务的结构、过程和结果。

证据回顾

通过搜索 CINAHL、MEDLINE 和 EMBASE 数据库进行了本次范围综述。由三名独立评审员筛选文章。选择文章的数据按 Donabedian 质量框架的类别进行组织:结构、流程和结果。

结果

在根据纳入/排除标准筛选标题/摘要和全文后,有 26 篇文章被纳入;92%(n=24)来自美国。随访服务由指定的创伤中心提供,并由多种卫生学科提供。随访采用多种方式(面对面/远程医疗)进行。协议和指南有助于为非医师主导的服务提供随访护理。确定了持续存在的健康问题,包括漏诊的损伤、疼痛和感染。没有确定接收者的标准化标准,也没有确定随访的时间或频率。参与随访服务的患者更有可能参与其他医疗服务。患者报告对随访护理满意。

结论

重大创伤患者的随访服务提供方式存在很大差异。进一步的评估应侧重于患者、家庭和组织的结局。确定谁最有可能受益、何时以及如何提供随访护理是改善结局的重要下一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc12/9462116/004333fc34f5/bmjopen-2022-060902f01.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索