Intensive care discharge summaries for general practice staff: a focus group study
Intensive care discharge summaries for general practice staff: a focus group study
复制标题
DOI：
10.3399/bjgp16x688045
复制
发表时间：
2016-12-01
影响因子：
5.9
通讯作者：
Xyrichis, Andreas
中科院分区：
文献类型：
--
作者：
Bench, Suzanne;Cornish, Jocelyn;Xyrichis, Andreas
背景了解出院后如何为患者和亲属提供支持是英国的一项研究重点。重症监护病房 (ICU) 出院总结是向全科医生提供协调持续护理所需信息的一种简单方法，但几乎没有证据可以指导最佳实践。目的本研究旨在更好地了解全科医生（全科医生和执业护士）在出院后支持前 ICU 患者及其家人的信息需求，并确定与 ICU 初级护理信息转移相关的障碍/促进因素。设计和设置这是一项针对整个治疗过程和参与者的定性探索性研究。英国方法在 2015 年 6 月至 9 月期间，对 15 名前 ICU 患者、4 名亲属和 20 名全科医生工作人员进行了录音焦点小组讨论，并辅以小组/个人访谈。通过问卷获取人口统计数据，并对定性数据进行专题分析。结果结果表明，出院信息体验存在差异，医院和全科医生以及患者/亲属之间的责任线模糊。护理的连续性因医院沟通延迟或不畅而受到影响；全科医生与重症监护患者的接触有限；以及缺乏对危重疾病影响的了解或缺乏可用于改善这些困难的资源。时间压力和信息技术分别是最常提到的障碍和促进因素。 结论 危重病后的有效康复需要采取协调和全面的方法，包括提供完整、及时和相关的 ICU 初级护理出院信息。卫生专业人员需要更好地了解危重疾病，患者和家属必须参与信息共享过程的各个方面。
BackgroundUnderstanding how patients and relatives can be supported after hospital discharge is a UK research priority. Intensive Care Unit (ICU) discharge summaries are a simple way of providing GPs with the information they require to coordinate ongoing care, but little evidence is available to guide best practice.AimThis study aimed at better understanding the information needs of GP staff (GPs and practice nurses) supporting former patients of ICUs and their families following discharge from hospital, and identifying the barriers/facilitators associated with ICU-primary care information transfer.Design and settingThis was a qualitative exploratory study of practices and participants throughout the UK.MethodAudiotaped focus group discussions, complemented by small-group/individual interviews, were conducted with 15 former patients of ICUs, four relatives, and 20 GP staff between June and September 2015. Demographic data were captured by questionnaire and qualitative data were thematically analysed.ResultsFindings suggest variability in discharge information experiences and blurred lines of responsibility between hospital and GP staff, and patients/relatives. Continuity of care was affected by delayed or poor communication from the hospital; GPs' limited contact with patients from critical care; and a lack of knowledge of the effects of critical illness or resources available to ameliorate these difficulties. Time pressures and information technology were, respectively, the most commonly mentioned barrier and facilitator.ConclusionEffective rehabilitation after a critical illness requires a coordinated and comprehensive approach, incorporating the provision of well-completed, timely, and relevant ICU-primary care discharge information. Health professionals need an improved understanding of critical illness, and patients and families must be included in all aspects of the information-sharing process.