Department of Emergency Medicine and Services, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
Päijät-Häme Social and Health Care, Lahti, Finland.
Scand J Caring Sci. 2024 Mar;38(1):169-176. doi: 10.1111/scs.13220. Epub 2023 Oct 8.
Transfers to the emergency department can be burdensome for the residents of long-term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse-led acute outreach service unit "Mobile hospital" (in Finnish, Liikkuva sairaala, LiiSa) has been providing on-site care to LTRCF residents to reduce transfers to the emergency department.
This study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six-month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A-D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.
Due to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%-22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%-30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%-41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.
LiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.
向急诊科的转运会给长期护理机构（LTRCF）的居民带来负担，并且经常导致不良后果。自 2019 年 3 月以来，一个由护士领导的急性外展服务单位“移动医院”（芬兰语：Liikkuva sairaala，LiiSa）一直为 LTRCF 居民提供现场护理，以减少向急诊科的转院。
本研究比较了在埃斯波和考尼艾宁的两个六个月期间 LTRCF 中进行的紧急医疗服务（EMS）任务的数量和紧急程度：在实施 LiiSa 之前和使用 LiiSa 期间。在芬兰，EMS 任务分为四类（A-D），其中 A 类任务最紧急。这些类别用于研究对任务紧急程度的影响。
由于 LiiSa 的实施，EMS 任务的数量减少了 16.8%（95%置信区间 10.6%-22.6%，p<0.001），D 类任务的数量减少了 19.8%（7.1%-30.8%，p=0.003），C 类任务的数量减少了 30.3%（17.3%-41.3%，p<0.001）。A 类和 B 类任务数量的变化没有统计学意义。
LiiSa 有助于避免许多体弱的 LTRCF 患者向急诊科转院，并且没有阻碍 EMS 对真正紧急情况患者的护理。
