Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
System Performance, Emergency Health Services, Halifax, Nova Scotia, Canada.
BMJ Open. 2023 Feb 16;13(2):e066645. doi: 10.1136/bmjopen-2022-066645.
Discharging older adults with frailty home from the emergency department (ED) poses unique challenges due to multiple interacting physical and social problems. Paramedic supportive discharge services help overcome these challenges by adding in-home assessment and/or interventions. Our objective is to describe existing paramedic programmes designed to support discharge from the ED or hospital to avoid unnecessary hospital admissions. A comprehensive description of paramedic supportive discharge services will be conducted by mapping the literature to describe: (1) why such programmes are needed; (2) who is being targeted, making referrals and delivering the services and (3) what assessments and interventions are offered.
We will include studies that focus on expanded paramedic roles (community paramedicine) and extended scope postdischarge from the ED or hospital. All study designs will be included with no limit by language. We will include peer-reviewed articles and preprints and a targeted search of grey literature from January 2000 to June 2022. The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute methodology. We will use a search strategy designed by a health science librarian to search MEDLINE All (Ovid), CINAHL Full Text (EBSCO), Embase (Elsevier) and Scopus (Elsevier) for eligible studies from 2000 to present. Two independent reviewers will conduct screening and full-text review. Data extraction will be conducted by one reviewer and verified by another. We will report our findings descriptively by charting trends in the research.
Research ethics review is not required as this is a scoping review comprised published studies. The results of this research will be published in a manuscript and presented at national and international geriatric and emergency medicine conferences. This research will inform future implementation studies on community paramedic supportive discharge services.
This scoping review protocol was registered in Open Science Framework and can be found here: https://doi.org/10.17605/OSF.IO/X52P7.
由于存在多种相互作用的身体和社会问题，将虚弱的老年人从急诊科（ED）出院回家具有独特的挑战。护理人员支持的出院服务通过增加家庭评估和/或干预措施来帮助克服这些挑战。我们的目标是描述旨在支持从 ED 或医院出院以避免不必要的住院的现有护理人员计划。通过将文献映射到描述内容，全面描述护理人员支持的出院服务：（1）为什么需要此类计划；（2）目标人群是谁，进行转诊和提供服务；（3）提供哪些评估和干预措施。
我们将包括重点关注扩展护理人员角色（社区护理医学）和从 ED 或医院出院后扩展范围的研究。所有研究设计都将被包括在内，不受语言限制。我们将包括同行评议的文章和预印本，并从 2000 年 1 月到 2022 年 6 月，对灰色文献进行有针对性的搜索。拟议的范围审查将按照 Joanna Briggs 研究所的方法进行。我们将使用由健康科学图书馆员设计的搜索策略在 2000 年至今的 MEDLINE All（Ovid）、CINAHL Full Text（EBSCO）、Embase（Elsevier）和 Scopus（Elsevier）中搜索合格的研究。两名独立的审查员将进行筛选和全文审查。数据提取将由一名审查员进行，并由另一名审查员验证。我们将通过图表趋势描述性地报告研究结果。
由于这是一项包含已发表研究的范围审查，因此不需要进行研究伦理审查。研究结果将以手稿的形式发表，并在国家和国际老年医学和急诊医学会议上发表。这项研究将为未来关于社区护理人员支持的出院服务的实施研究提供信息。
本范围审查方案已在开放科学框架中注册，可在此处找到：https://doi.org/10.17605/OSF.IO/X52P7。
