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转移风险。保障母婴安全:英国救护车服务视角。

Displaced risk. Keeping mothers and babies safe: a UK ambulance service lens.

作者信息

Heys Stephanie, Main Camella, Humphreys Aimee, Torrance Rachael

机构信息

North West Ambulance Service NHS Trust; University of Central Lancashire https://orcid.org/0000-0002-4379-9022.

London Ambulance Service NHS Trust.

出版信息

Br Paramed J. 2023 Sep 1;8(2):52-56. doi: 10.29045/14784726.2023.9.8.2.52.

Abstract

AIM

The aim of this professional practice paper is to provide a critical commentary on displaced risk among perinatal and neonatal patients attended to by the ambulance service.

BACKGROUND

NHS services across the United Kingdom are currently facing unprecedented demand and increased scrutiny in their ability to provide safe and personalised care to patients. While current focus in the system centres around addressing social care demand, hospital bed capacity, planned care waiting times, staffing and ambulance handover delays, a less explored cohort of patients impacted by the current healthcare crisis is perinatal and neonatal populations attended to by the ambulance service. Little focus has been paid within national agendas to the care provided to women and babies outside of planned maternity and obstetric care. A case is presented to highlight the importance of considering urgent and emergency maternity care provision provided by the ambulance service, and the impact of 'displaced risk' due to the current pressures within healthcare systems.

CONCLUSION

Placed in a national context, drawing upon current independent reviews into maternity services, national transformation agendas and the most recent MBRRACE-UK confidential enquiry into maternal deaths and morbidity, a case is made to commissioners and Integrated Care Systems to focus on and invest in the unplanned pre-hospital care of maternity and neonatal patients. Recognition of the ambulance service as a key provider of care to this cohort of patients is paramount, calling on services and systems to work together on realising and addressing displaced risk for perinatal populations across the United Kingdom. A system approach that acknowledges the need for high-quality care at every point of contact and equitability in access to services for pregnant, postpartum and neonatal patients is vital.

摘要

目的

本专业实践论文旨在对救护服务所接诊的围产期和新生儿患者的转移风险进行批判性评论。

背景

英国各地的国民保健服务(NHS)目前正面临前所未有的需求,且在为患者提供安全和个性化护理的能力方面受到越来越多的审查。虽然目前系统的重点集中在应对社会护理需求、医院床位容量、计划内护理等待时间、人员配备和救护车交接延迟等方面,但当前医疗保健危机影响的一个较少被探讨的患者群体是由救护服务接诊的围产期和新生儿人群。国家议程中很少关注计划外的产妇和产科护理之外为妇女和婴儿提供的护理。本文通过一个案例来强调考虑救护服务提供的紧急和应急产妇护理的重要性,以及由于医疗系统当前压力导致的“转移风险”的影响。

结论

从国家层面来看,借鉴当前对产妇服务的独立审查、国家转型议程以及英国产妇和儿童健康保密调查(MBRRACE-UK)对孕产妇死亡和发病情况的最新调查结果,本文呼吁专员和综合医疗系统关注并投资于产妇和新生儿患者的非计划院前护理。认识到救护服务是这一患者群体护理的关键提供者至关重要,呼吁各服务机构和系统共同努力,识别并解决英国围产期人群的转移风险。一种承认在每个接触点都需要高质量护理以及孕妇、产后和新生儿患者获得服务公平性的系统方法至关重要。

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