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[多专业视角下跨部门合作预防老年患者术后谵妄的定性研究]

[Multiprofessional perspectives on intersectoral collaboration for the prevention of postoperative delirium in older patients-A qualitative study].

作者信息

Krutter Simon, Muzzana Chiara, Flamm Maria, Iglseder Bernhard, Piccoliori Giuliano, Ruffini Ingrid, Kutschar Patrick, Ausserhofer Dietmar

机构信息

Institut für Pflegewissenschaft und -praxis, Paracelsus Medizinische Privatuniversität, Strubergasse 21, 5020, Salzburg, Österreich.

Zentrum für Public Health und Versorgungsforschung, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich.

出版信息

Z Gerontol Geriatr. 2025 May 5. doi: 10.1007/s00391-025-02442-4.

Abstract

BACKGROUND

The prevention of postoperative delirium (POD) in older adults requires interprofessional collaboration among all healthcare professionals (HCP) involved in the continuum of care.

OBJECTIVE

This study investigated the question of how HCPs experience the interprofessional prevention of POD in older adults within the continuum of care. Additionally, it examined the challenges and desired changes in the intersectoral communication and collaboration for prevention of POD.

METHODS

This multicenter study was carried out with a qualitative research approach. To explore the experiences of HCPs a total of 21 semistructured expert interviews were conducted with general practitioners, geriatricians, anesthesiologists, surgeons and nurses across the 2 study regions Salzburg County and South Tyrol. The interviews were analyzed using content analysis.

RESULTS

The results show that the interviewed HCPs already implement measures to prevent POD but these predominantly focus on identifying patients at risk in the inpatient sector. Information about risk factors is not systematically shared between disciplines or across the intersectoral continuum of care. Structures and processes for intersectoral communication and collaboration in the prevention of POD over the continuum of care are largely missing.

CONCLUSION

To improve the prevention of POD in older adults efforts should be made to enhance intersectoral and interprofessional collaboration and communication between the HCPs involved. The development of a shared instrument for the systematic identification and documentation of relevant risk factors across the continuum of care could support the prevention of POD.

摘要

背景

预防老年人术后谵妄(POD)需要参与连续护理的所有医疗保健专业人员(HCP)之间进行跨专业协作。

目的

本研究调查了医疗保健专业人员如何在连续护理中体验对老年人POD的跨专业预防这一问题。此外,还研究了预防POD的跨部门沟通与协作中的挑战以及期望的变化。

方法

本多中心研究采用定性研究方法。为探究医疗保健专业人员的体验,在萨尔茨堡县和南蒂罗尔这两个研究区域,对全科医生、老年病科医生、麻醉师、外科医生和护士共进行了21次半结构化专家访谈。采用内容分析法对访谈进行分析。

结果

结果表明,接受访谈的医疗保健专业人员已经在实施预防POD的措施,但这些措施主要集中在识别住院部门的高危患者。各学科之间或跨部门连续护理过程中,风险因素信息并未得到系统共享。在连续护理过程中预防POD的跨部门沟通与协作的结构和流程基本缺失。

结论

为改善对老年人POD的预防,应努力加强相关医疗保健专业人员之间的跨部门和跨专业协作与沟通。开发一种共享工具,用于在连续护理过程中系统识别和记录相关风险因素,可能有助于预防POD。

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