Acute asthma management by a pediatric after-hours call center.
Acute asthma management by a pediatric after-hours call center.
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儿科非工作时间呼叫中心的急性哮喘管理。
DOI：
10.1089/tmj.2009.0005
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Strunk,RobertC
中科院分区：
文献类型：
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作者：
Nelson,KyleA;Freiner,Donna;Garbutt,Jane;Trinkaus,Kathryn;Bruns,Julie;Sterkel,Randal;Smith,SharonR;Strunk,RobertC
描述一个由护士组成的儿科下班后呼叫中心（AHCC）使用的哮喘管理方案，该方案包括基于严重程度的家庭治疗建议和随访电话评估。对2004年1月1日至2004年6月30日哮喘咨询的电话记录进行回顾性识别和审查。使用描述性统计量报告患者人口统计学资料、首次呼叫时症状严重度区域（红色、黄色或绿色）的频率、指定提供护理建议的呼叫处置频率（包括家庭治疗建议和寻求急诊科[艾德]护理），以及护士在建议的家庭治疗后重新评估患者时，首次呼叫和随访呼叫之间严重度区域的变化。在研究期间，AHCC护士管理了3，632个哮喘呼叫（2，439个初始呼叫; 1，193个随访呼叫）。初始呼叫主要被分类为红色（28%）或黄色（42%）严重区域; 27%为绿色区域，3%无法分类。52%的红色或黄色严重度区域的初始呼叫涉及家庭治疗建议; 50%的红色区域和63%的黄色区域呼叫在随访呼叫评估中改善了严重度区域。28%有家庭治疗建议的患者在随访电话护士重新评估时被转诊到艾德。这种基于电话的护士工作的儿科急性哮喘管理方案包括提供基于严重程度的家庭治疗建议和随访评估，并改善了许多急性加重儿童的症状。该方案也可能在其他地区取得成功，并可能改善结局，例如减少艾德就诊。
To describe an asthma management protocol used in a nurse-staffed pediatric After-Hours Call Center (AHCC) that incorporates severity-based home treatment recommendations and follow-up call assessments. Call records for asthma advice from January 1, 2004 to June 30, 2004 were identified retrospectively and reviewed. Descriptive statistics were used to report patient demographics, frequencies of symptom severity zones (Red, Yellow, or Green) at initial calls, frequencies of call dispositions designating care advice provided (including home treatment recommendations and seeking emergency department [ED] care), and changes in severity zones between initial calls and follow-up calls when nurses reassessed patients after recommended home treatment. During the study period, 3,632 asthma calls (2,439 initial; 1,193 follow-up) were managed by AHCC nurses. Initial calls were classified mostly as Red (28%) or Yellow (42%) severity zones; 27% were Green zone and 3% could not be categorized. Fifty-two percent of initial calls with Red or Yellow severity zones involved home treatment recommendations; 50% of those Red zone and 63% of those Yellow zone calls had improved severity zones at follow-up call assessments. Twenty-eight percent of patients with home treatment recommendations were referred to the ED at the time of follow-up call nurse reassessment. This telephone-based nurse-staffed pediatric acute asthma management protocol includes provision of severity-based home treatment recommendations and follow-up assessments, and improved symptoms for many children with acute exacerbations. This protocol may also be successful in other locations and may improve outcomes, such as reduction in ED visits.