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用于经直肠顺行灌肠的儿科患者的医疗警示卡,以增强意识。

Medical Alert Cards for Pediatric Patients With Antegrade Continence Enemas to Enhance Awareness.

机构信息

Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, Missouri.

Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, Missouri; Department of Surgery, University of Missouri-Kansas City, Kansas City, Missouri.

出版信息

J Surg Res. 2024 Nov;303:206-214. doi: 10.1016/j.jss.2024.09.020. Epub 2024 Oct 5.

Abstract

INTRODUCTION

The antegrade continence enema (ACE) is a surgical technique that establishes a route for colonic irrigation, necessitating a detailed comprehension of the procedural methodology, including the conduit construction, the catheters selection, and the administration of irrigation solutions. It is critical to disseminate comprehensive information regarding ACE procedures to health-care professionals and caregivers to enhance their understanding and support management of patients undergoing this intervention. This study aims to evaluate the efficacy of a novel educational tool designed to augment the knowledge base of physicians and caregivers regarding ACE procedures.

METHODS

Medical alert cards were conceptualized for patients managed with ACEs via an appendicostomy, neoappendicostomy, or cecostomy. These cards included essential information such as (1) contact details of the health-care team, (2) specifics of the surgical procedure, (3) criteria for emergency department referral, and (4) bespoke patient-specific information. A single-institution survey was conducted to assess the cards' role in improving awareness of ACE procedures among health-care providers and caregivers and guiding management of patients with ACEs. The study adhered to Consensus-Based Checklist for Reporting of Survey Studies guidelines.

RESULTS

Twenty-seven responses were collected from 18 health-care providers and nine caregivers. A significant majority (n = 24, 88%) affirmed the cards' effectiveness in providing detailed information about individual patients. The design and layout of the card were well-received by 93% (n = 25) of respondents, with a median readability score of 8 (interquartile range 7-10). Additionally, some providers (n = 3, 17%) highlighted the card's utility in facilitating patient referrals to specialized care centers. Suggestions for improvement included adding information about different types of tubes, enhancing readability, and optimizing the visual representation of the conduit.

CONCLUSIONS

Medical alert cards demonstrated a significant potential to improve understanding of ACEs among health-care providers and caregivers. The cards aid in informing stakeholders about the ACE procedure, guiding the child's management, and referring the patients to specialized care facilities when necessary.

摘要

简介

顺行性灌肠(ACE)是一种建立结肠灌洗途径的手术技术,需要详细了解手术方法,包括导管的构建、导管的选择以及灌洗溶液的施用。向医疗保健专业人员和护理人员传播有关 ACE 程序的全面信息对于增强他们对接受该干预措施的患者的理解和支持管理至关重要。本研究旨在评估一种新的教育工具,该工具旨在增强医生和护理人员对 ACE 程序的知识基础。

方法

为通过阑尾造口术、新阑尾造口术或乙状结肠造口术接受 ACE 治疗的患者设计了医疗警报卡。这些卡片包括以下重要信息:(1)医疗团队的联系方式,(2)手术程序的具体细节,(3)紧急部门转诊标准,以及(4)特定于患者的信息。进行了一项单机构调查,以评估这些卡片在提高医疗保健提供者和护理人员对 ACE 程序的认识以及指导 ACE 患者管理方面的作用。该研究遵循共识为基础的报告调查研究指南。

结果

从 18 名医疗保健提供者和 9 名护理人员中收集了 27 份回复。绝大多数(n=24,88%)肯定了这些卡片在提供有关个别患者的详细信息方面的有效性。卡片的设计和布局得到了 93%(n=25)的受访者的好评,中位数可读性评分为 8(四分位距 7-10)。此外,一些提供者(n=3,17%)强调了卡片在促进患者转介到专门护理中心方面的作用。改进建议包括添加有关不同类型的导管的信息,提高可读性,以及优化导管的视觉表示。

结论

医疗警报卡在提高医疗保健提供者和护理人员对 ACE 的理解方面显示出了显著的潜力。这些卡片有助于向利益相关者告知 ACE 程序,指导患儿的管理,并在必要时将患者转介到专门的护理机构。

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