卫生保健专业人员在医院中有关行动和安全的决策：范围综述。

Curtin School of Allied Health, Curtin University, Bentley, Western Australia, Australia.

enAble Institute, Curtin University, Bentley, Western Australia, Australia.

Phys Ther. 2023 May 4;103(5). doi: 10.1093/ptj/pzad024.

OBJECTIVE

Mobility dysfunction can have an impact on safety, and this fact is particularly relevant to hospital settings. There are no clear standards for how health care professionals should approach the aim to encourage mobility without compromising safety. The objective of this scoping review was to identify factors that shape health care professionals' decision making for people in hospitals, in situations in which mobility and safety are taken into consideration.

METHODS

For this scoping review, 4 databases (Medline, CINAHL, PubMed, and Scopus) were searched. Terms previously agreed upon were used to identify peer-reviewed articles related to decision making by health care professionals in hospital settings (acute and rehabilitation), in which safety and mobility were factors for consideration. An initial screening of titles and abstracts was conducted by a single reviewer. Two reviewers independently screened the full texts of the remaining articles. The key findings of the articles were synthesized to determine common themes.

RESULTS

After 10,717 articles were screened, 28 met the inclusion criteria. Ten themes influencing decision making were identified: Clinical factors assessed; health care professional experience; limited use of standardized tests; impact of institutional governance; risk/benefit trade-off; capacity for decision making; role of the multidisciplinary team; families and others; communication; and fear of negative outcomes.

CONCLUSION

A wide range of factors influence health care professionals' decision making. The decisions can be complex, and individual priorities may vary in the balancing of safety with promotion of independence. Health care professionals rely on experience, clinical judgment, and shared decision making.

IMPACT

This review brings attention to many factors that contribute to decision making when mobility and safety are the factors. Health care professionals should include patients' values and monitor the impact of their personal preferences on this process.

目的

行动障碍会对安全产生影响，这一事实在医院环境中尤为重要。目前，对于医护人员在不影响安全的前提下促进行动能力的目标，并没有明确的标准。本研究旨在明确在考虑行动能力和安全的情况下，影响医护人员决策的因素。

方法

为了进行本次范围界定综述，我们检索了 4 个数据库（Medline、CINAHL、PubMed 和 Scopus）。使用事先商定的术语，以确定与医院环境（急性和康复）中医护人员决策相关的同行评审文章，这些文章中安全和行动能力是需要考虑的因素。由一名评审员对标题和摘要进行初步筛选，然后两名评审员独立筛选其余文章的全文。对文章的关键发现进行综合，以确定共同的主题。