Assessing and improving out-of-hours palliative care in a deprived community: a rapid appraisal study
Assessing and improving out-of-hours palliative care in a deprived community: a rapid appraisal study
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DOI：
10.1177/0269216309356030
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发表时间：
2010-07-01
影响因子：
4.4
通讯作者：
Murray, S. A.
中科院分区：
文献类型：
--
作者：
Fergus, C. J. Y.;Chinn, D. J.;Murray, S. A.
最近的变化，在英国的小时初级保健产生了关注姑息治疗患者的护理。本研究的目的是确定关键的挑战和改进的混合城市和农村贫困地区的非工作时间姑息治疗。我们整合了三个来源的数据：与患者和专业人士的访谈，对服务的直接观察和常规统计。提供护理的关键问题是良好沟通和提供信息的重要性，在工作时间外获得医疗护理的繁琐过程，专业人员绕过姑息治疗患者的常规工作时间外护理，以及不了解当地服务的从业人员提供的工作时间外护理。我们建议为姑息治疗患者提供强化的“特别说明”，在疾病早期完成并定期更新。如果常规护理不令人满意，应考虑为某些复杂患者提供绕过NHS 24的服务。
Recent changes to out-of-hours primary care in the UK have generated concerns about care for palliative care patients. The aim of this study was to identify key challenges and improvements to out-of-hours palliative care in a mixed urban and rural deprived area. We integrated data from three sources: interviews with patients and professionals, direct observations of services, and routine statistics. Key issues in the provision of care were the importance of good communication and having information available, the unwieldy process of accessing medical care out of hours, professionals bypassing routine out-of-hours care for palliative care patients, and out-of-hours care being provided by practitioners unaware of local services. We recommend provision to out-of-hours services of an enhanced 'special note' for palliative care patients, to be completed early in the course of the illness and updated regularly. The provision for certain complex patients to bypass NHS24 should be considered if routine care is not satisfactory.