Walker Natalie, Sherratt Cathy
Royal Bolton Hospital.
Edge Hill University.
MedEdPublish (2016). 2019 Jul 24;8:157. doi: 10.15694/mep.2019.000157.1. eCollection 2019.
This article was migrated. The article was marked as recommended. Background Literature reports disquiet in junior doctors' abilities in palliative care prescribing; including distress and low confidence ( Charlton and Smith, 2000). We confirmed similar findings following local research thus identifying a development need. This led to the design and implementation of a hand-held prescribing card. Objective Usefulness of the prescribing card in supporting foundation year one doctors was evaluated. We hypothesised this intervention would help improve End of Life (EOL) care. Methods A mixed methods approach was employed using a specially designed questionnaire, distributed to 39 foundation year one doctors (doctors in their first year of practice after graduating from medical school). Focused questions were on utilisation, levels of prescribing confidence and exploring further interventions that might help, as well as feedback on card design. Results 25 doctors completed questionnaires; a response rate 86%. Almost half routinely used the card. 40% were not yet prescribing for EOL situations at the time of the study because of their specific job rotation (e.g. ophthalmology). The commonest motivator was accessibility. All doctors reported increased confidence in prescribing and approximately three quarters said it enhanced practice. "Usefulness" was the commonest free-response descriptor. Feelings included it being a good reference and preventing errors. A development idea included an electronic version. Conclusion Results highlight that a simple hand-held prescribing card is useful. To our knowledge, this is the first UK study of its kind employing an educational intervention in palliative care in a hospital setting. It is important to implement this educational intervention early to support doctors.
本文已迁移。该文章被标记为推荐文章。背景 文献报道初级医生在姑息治疗处方方面能力欠佳，包括苦恼和信心不足（查尔顿和史密斯，2000年）。我们在本地研究后证实了类似的发现，从而确定了一项发展需求。这导致了手持处方卡的设计和实施。目的 评估处方卡在支持一年级住院医生方面的实用性。我们假设这种干预将有助于改善临终关怀。方法 采用混合方法，使用专门设计的问卷，分发给39名一年级住院医生（医学院毕业后第一年实习的医生）。重点问题包括使用情况、处方信心水平、探索可能有帮助的进一步干预措施，以及对卡片设计的反馈。结果 25名医生完成了问卷，回复率为86%。几乎一半的人经常使用该卡片。40%的人在研究时由于其特定的轮岗（如眼科）尚未开具临终关怀处方。最常见的动机是可获取性。所有医生都表示开处方的信心有所增强，约四分之三的人表示这改善了实践。“有用”是最常见的自由回答描述词。感受包括它是一个很好的参考且能防止出错。一个改进想法包括电子版。结论 结果表明，一张简单的手持处方卡很有用。据我们所知，这是英国同类研究中首个在医院环境中对姑息治疗进行教育干预的研究。尽早实施这种教育干预以支持医生很重要。
