Associate Professor, Universidade Católica Portuguesa, Portugal.
Int J Palliat Nurs. 2024 Aug 2;30(8):432-443. doi: 10.12968/ijpn.2024.30.8.432.
The transfer of end-of-life patients to hospital via admission to an emergency service mainly happens because of a lack of community support nearby and a lack of resources in palliative care.
This study aimed to define the concept of avoidable admission to an emergency department for palliative patients.
An integrative literature review was performed. The results of this were put to a panel of palliative care experts via a Delphi process to determine their consensus and agreement with the statements.
The results of the two-step Delphi process reached a high level of consensus and agreement that patients with palliative needs accompanied by home palliative care teams should not go to the emergency department. There was a low level of consensus and agreement about the appropriate admission of a patient in pain in the absence of any information about previous community support.
The findings allowed the definition of an 'avoidable emergency admission', which is an emergency admission for any symptom or condition that could be supported in a home context or primary health care, or any emergency admission that does not require immediate nursing or medical intervention, nor leads to greater comfort or quality of life for the patient.
临终患者通过急诊入院转移至医院，主要是由于附近缺乏社区支持以及姑息治疗资源不足。
本研究旨在定义姑息治疗患者急诊可避免入院的概念。
进行了综合文献回顾。将这些结果通过德尔菲（Delphi）流程提交给一组姑息治疗专家，以确定他们对这些陈述的共识和一致性。
两步德尔菲流程的结果达到了高度的共识和一致性，即伴有家庭姑息治疗团队的姑息治疗需求患者不应去急诊。对于没有任何先前社区支持信息的疼痛患者的适当入院，共识和一致性程度较低。
研究结果允许对“可避免急诊入院”进行定义，即任何可以在家庭环境或初级保健中得到支持的症状或病情的急诊入院，或者任何不需要立即护理或医疗干预的急诊入院，也不会为患者带来更大的舒适度或生活质量。
