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改善急诊科患者护理的创伤知情护理(TIC)最佳实践。

Trauma-informed care (TIC) best practices for improving patient care in the emergency department.

作者信息

Ashworth Henry, Lewis-O'Connor Annie, Grossman Samara, Brown Taylor, Elisseou Sadie, Stoklosa Hanni

机构信息

Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, USA.

Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Int J Emerg Med. 2023 May 19;16(1):38. doi: 10.1186/s12245-023-00509-w.

DOI:10.1186/s12245-023-00509-w
PMID:37208640
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10197231/
Abstract

A patient's current or previous experience of trauma may have an impact on their health and affect their ability to engage in health care. Every year, millions of patients who have experienced physically or emotionally traumatic experiences present to emergency departments (ED) for care. Often, the experience of being in the ED itself can exacerbate patient distress and invoke physiological dysregulation. The physiological reactions that lead to fight, flight, or freeze responses can make providing care to these patients complex and can even lead to harmful encounters for providers. There is a need to improve the care provided to the vast number of patients in the ED and create a safer environment for patients and healthcare workers. One solution to this complex challenge is understanding and integrating trauma-informed care (TIC) into emergency services. The federal Substance Abuse and Mental Health Service Administration's (SAMHSA) six guiding principles of TIC offer a universal precaution framework that ensures quality care for all patients, providers, and staff in EDs. While there is growing evidence that TIC quantitatively and qualitatively improves ED care, there is a lack of practical, emergency medicine-specific guidance on how to best operationalize TIC. In this article, using a case example, we outline how emergency medicine providers can integrate TIC into their practice.

摘要

患者当前或既往的创伤经历可能会对其健康产生影响,并影响他们接受医疗保健的能力。每年,数百万有身体或情感创伤经历的患者前往急诊科(ED)就诊。通常,身处急诊科本身的经历会加剧患者的痛苦,并引发生理失调。导致战斗、逃跑或冻结反应的生理反应会使为这些患者提供护理变得复杂,甚至可能给医护人员带来有害的接触。有必要改善急诊科为大量患者提供的护理,并为患者和医护人员创造一个更安全的环境。应对这一复杂挑战的一个解决方案是理解创伤知情护理(TIC)并将其融入急诊服务中。联邦药物滥用和心理健康服务管理局(SAMHSA)的TIC六项指导原则提供了一个通用的预防框架,可确保为急诊科的所有患者、医护人员和工作人员提供优质护理。虽然越来越多的证据表明TIC在数量和质量上改善了急诊护理,但对于如何最好地实施TIC,缺乏实用的、针对急诊医学的指导。在本文中,我们通过一个案例示例,概述了急诊医学提供者如何将TIC融入他们的实践中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e86/10197231/3ed17b48f961/12245_2023_509_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e86/10197231/3ed17b48f961/12245_2023_509_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e86/10197231/3ed17b48f961/12245_2023_509_Fig1_HTML.jpg

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2
Trauma-informed Care Interventions in Emergency Medicine: A Systematic Review.创伤知情的急诊医学护理干预:系统评价。
West J Emerg Med. 2022 Apr 13;23(3):334-344. doi: 10.5811/westjem.2022.1.53674.
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Trauma-Informed Nursing Leadership: Definitions, Considerations and Practices in the Context of the 21st Century.
急诊科中人口贩运受害者护理路径的要素:一项映射综述。
Worldviews Evid Based Nurs. 2025 Feb;22(1):e12761. doi: 10.1111/wvn.12761. Epub 2024 Dec 9.
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Effectiveness of Trauma-Informed Care Implementation in Health Care Settings: Systematic Review of Reviews and Realist Synthesis.创伤知情护理在医疗保健环境中的实施效果:系统评价综述和现实主义综合。
Perm J. 2024 Mar 15;28(1):135-150. doi: 10.7812/TPP/23.127. Epub 2024 Mar 6.
创伤知情护理领导力:21 世纪背景下的定义、考虑因素与实践。
Nurs Leadersh (Tor Ont). 2021 Sep;34(3):24-33. doi: 10.12927/cjnl.2021.26596.
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Adverse Childhood Experiences and Healthcare Utilization of Children in Pediatric Emergency Departments.儿童不良经历与儿科急诊患儿的医疗利用
J Pediatr. 2022 Jan;240:206-212. doi: 10.1016/j.jpeds.2021.09.016. Epub 2021 Sep 20.
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A Trauma-Informed Approach to the Medical History: Teaching Trauma-Informed Communication Skills to First-Year Medical and Dental Students.以创伤知情为导向的病史采集方法:向医学生和牙科学员教授创伤知情沟通技巧。
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Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context.创伤知情医学教育(TIME):推进课程内容和教育背景。
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