Parallels Between Efforts to Improve Geriatric and Pediatric Emergency Care.
Parallels Between Efforts to Improve Geriatric and Pediatric Emergency Care.
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改善老年和儿童急诊护理工作的相似之处。
DOI：
10.1016/j.annemergmed.2022.05.005
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发表时间：
2022
影响因子：
6.2
通讯作者：
CamargoJr,CarlosA
中科院分区：
文献类型：
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作者：
Boggs,KrislynM;Sullivan,AshleyF;Samuels-Kalow,MargaretE;CamargoJr,CarlosA
我们怀着极大的兴趣阅读了 Kennedy 等人 1 发表的题为“美国老年急诊科认证计划的实施和采用”的文章。我们赞扬作者详细介绍了在全国范围内改善老年患者急诊护理方面取得的进展，包括描述了正式确定急诊科 (ED)，以便通过老年急诊科认证 (GEDA) 计划为老年患者提供高质量护理做好准备。 1 作者对 GEDA 计划的长期奉献强化了为任何质量改进计划确定“冠军”的重要性。在急诊科内，如 GEDA 认证标准中所述，这可能是一名医师冠军，但也可能是一名护士或其他临床医生（例如医师助理）。这些努力类似于改善儿科急诊护理的持续努力，我们相信，从这些并行的质量改进工作中可能会分享经验教训。值得注意的是，任命一名儿科紧急护理协调员 (PECC) 已被认为是急诊室为提高儿科准备情况可以采取的最重要的一步。 2 2006 年，美国国家医学院建议所有急诊室同时任命医生和护士 PECC。该建议已得到包括美国急诊医师学会在内的多个专业协会的认可。 3 简而言之，PECC 管理其急诊室的儿科急诊护理，他们可以完成各种活动（例如，领导教育活动、确保急诊室拥有适合儿童的设备）。虽然 GEDA 需要一名医师冠军，但也许需要不止一种类型的冠军才是理想的（例如，医生和护士冠军）。我们鼓励为每个急诊室任命一种以上临床类型的“老年紧急护理协调员（GECC）”，同时建议改善儿科紧急护理。
With great interest, we read the article by Kennedy et al 1 titled,“Reach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States.” We commend the authors for detailing the progress made toward improving emergency care for older patients nationwide, including describing the formal identification of emergency departments (EDs) more prepared to provide high-quality care for older patients through the Geriatric Emergency Department Accreditation (GEDA) program. 1 The authors’ long-standing dedication to the GEDA program reinforces the importance of identifying a “champion” for any quality improvement initiative. Within the ED, this might be a physician champion, as noted in the GEDA accreditation criteria, but it also might be a nurse or another clinician (eg, physician assistant).These efforts resemble ongoing efforts to improve pediatric emergency care, and we believe that there may be shared lessons from these parallel quality improvement efforts. Notably, the appointment of a pediatric emergency care coordinator (PECC) has been identified as the most important step that an ED can take to improve its pediatric readiness. 2 In 2006, the National Academy of Medicine recommended that all EDs appoint both physician and nurse PECCs. This recommendation has been endorsed by several professional societies, including the American College of Emergency Physicians. 3 Briefly, a PECC manages pediatric emergency care in their ED, and they can complete various activities (eg, leading educational activities, ensuring that the ED has appropriate equipment for children). Although a physician champion is required for GEDA, perhaps requiring more than one type of champion would be ideal (eg, both physician and nurse champions). We encourage the appointment of “geriatric emergency care coordinators (GECC)” of more than one clinical type for each ED, in parallel with what is being recommended for the improvement of pediatric emergency care.