Masbi Mohammad, Tavakoli Nader, Dowlati Mohsen
Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran.
BMC Emerg Med. 2024 Dec 18;24(1):238. doi: 10.1186/s12873-024-01160-1.
The ability of hospitals to provide special care services for critically ill or injured patients during emergencies and disasters poses very significant challenges that necessitate the response in-place plans. the increasing frequency of such events, coupled with limited hospital resources and increasing patient volumes, underscores the urgency of addressing these issues. Specifically, this study aims to identify the challenges faced by hospitals in providing special services during disasters.
This scoping review, conducted in 2024, based upon the framework developed by Arksey and O'Malley. An extensive search of Literature searching was performed using gray literature and databases including Google Scholar, PubMed, Web of Science, and Scopus. Applying the selection criteria, a total of 33 relevant studies were identified that discuss the challenges faced when providing special care services in hospitals during emergencies and disasters. Results are presented in accordance with the PRISMA checklist to ensure quality and transparency. Data was analyzed through a systematic coding process where common themes across the studies were identified.
This review identified 15 distinct challenges associated with providing special care services in hospitals during emergencies and disasters: limited resources, inadequate infrastructure, lack of pre-hospital care, financial constraints, failures in the emergency response system, triage, deficiencies in management structure, planning, and preparation, communication and coordination deficits, training and protocols development, employee welfare challenges, challenges of continuity of care, increased demand, different and complex needs of patients, ethical challenges, imbalance in distribution of service resources.
Response in a hospital to the needs of special care during a disaster has to be responded to with more effective preparedness through comprehensive disaster preparedness plans, better communication and coordination, and training of staff and allocation of resources. In particular, standardized triage protocols and ethical frameworks will provide the foundation for the optimization of resource use in emergency responses. Better communication among departments and also with other outside organizations will improve how resources are used to better achieve good patient outcomes within emergency responses.
医院在紧急情况和灾难期间为重症或受伤患者提供特殊护理服务的能力面临着非常重大的挑战，这需要制定应急计划。此类事件的频率不断增加，再加上医院资源有限和患者数量不断增加，凸显了解决这些问题的紧迫性。具体而言，本研究旨在确定医院在灾难期间提供特殊服务时面临的挑战。
本综述于2024年进行，基于阿克西和奥马利开发的框架。通过灰色文献和包括谷歌学术、PubMed、科学网和Scopus在内的数据库进行了广泛的文献检索。应用选择标准，共确定了33项相关研究，这些研究讨论了在紧急情况和灾难期间医院提供特殊护理服务时面临的挑战。结果按照PRISMA清单呈现，以确保质量和透明度。通过系统编码过程对数据进行分析，确定了各项研究中的共同主题。
本综述确定了与在紧急情况和灾难期间医院提供特殊护理服务相关的15个不同挑战：资源有限、基础设施不足、院前护理缺乏、资金限制、应急系统故障、分诊、管理结构、规划和准备方面的缺陷、沟通与协调不足、培训和协议制定、员工福利挑战、护理连续性挑战、需求增加、患者不同且复杂的需求、伦理挑战、服务资源分配不均衡。
医院应对灾难期间特殊护理需求时，必须通过全面的灾难准备计划、更好的沟通与协调、员工培训和资源分配，以更有效的准备措施来应对。特别是，标准化的分诊协议和伦理框架将为优化应急资源利用提供基础。各部门之间以及与其他外部组织之间更好的沟通将改善资源利用方式，以便在应急响应中更好地实现良好的患者治疗效果。
