评估有医疗复杂性的儿童的急诊服务提供者和护理人员的信息需求和工作流程。

An assessment of information needs and workflows for emergency service providers and caregivers of children with medical complexity.

机构信息

University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE, USA.

Children's Hospital and Medical Center, Omaha, NE, USA.

出版信息

BMC Health Serv Res. 2023 May 8;23(1):453. doi: 10.1186/s12913-023-09366-y.

DOI:10.1186/s12913-023-09366-y

PMID:37158902

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10166030/

Abstract

BACKGROUND

The goal of Project Austin, an initiative to improve emergency care for rural children who are medically complex (CMC), is to provide an Emergency Information Form (EIF) to their parents/caregivers, to local Emergency Medical Services, and Emergency Departments. EIFs are standard forms recommended by the American Academy of Pediatrics that provide pre-planned rapid response instructions, including medical conditions, medications, and care recommendations, for emergency providers. Our objective is to describe the workflows and perceived utility of the provided emergency information forms (EIFs) in the acute medical management of CMC.

METHODS

We sampled from two key stakeholder groups in the acute management of CMC: four focus groups with emergency medical providers from rural and urban settings and eight key informant interviews with parents/caregivers enrolled in an emergency medical management program for CMC. Transcripts were thematically analyzed in NVivo© by two coders using a content analysis approach. The thematic codes were combined into a codebook and revised the themes present through combining relevant themes and developing of sub-themes until they reached consensus.

RESULTS

All parents/caregivers interviewed were enrolled in Project Austin and had an EIF. Emergency medical providers and parents/caregivers supported the usage of EIFs for CMC. Parents/caregivers also felt EIFs made emergency medical providers more prepared for their child. Providers identified that EIFs helped provide individualized care, however they were not confident the data was current and so felt unsure they could rely on the recommendations on the EIF.

CONCLUSION

EIFs are an easy way to engage parents, caregivers, and emergency medical providers about the specifics of a care for CMC during an emergency. Timely updates and electronic access to EIFs could improve their value for medical providers.

摘要

背景

奥斯汀项目是一项旨在改善农村复杂医疗儿童（CMC）急诊护理的计划，其目标是向父母/照顾者、当地紧急医疗服务机构和急诊部门提供紧急信息表（EIF）。EIF 是美国儿科学会推荐的标准表格，为急诊提供者提供了预先计划的快速反应说明，包括医疗状况、药物和护理建议。我们的目标是描述在 CMC 的急性医疗管理中提供的紧急信息表（EIF）的工作流程和感知效用。

方法

我们从 CMC 急性管理的两个主要利益相关者群体中抽取样本：来自农村和城市环境的四名紧急医疗提供者的焦点小组和八名参加 CMC 紧急医疗管理计划的父母/照顾者的关键知情人访谈。使用 NVivo© 对两个编码员的转录本进行主题分析，使用内容分析方法。主题代码被合并到一个代码簿中，并通过合并相关主题和开发子主题来修改主题，直到达成共识。

结果

所有接受采访的父母/照顾者都参加了奥斯汀项目，并拥有 EIF。紧急医疗提供者和父母/照顾者都支持使用 EIF 进行 CMC。父母/照顾者还认为 EIF 使紧急医疗提供者对他们的孩子更有准备。提供者认为 EIF 有助于提供个性化护理，但他们对数据是否为最新表示怀疑，因此不确定他们是否可以依赖 EIF 上的建议。