老年人及其院内转运体验

Dillon Bille, Nancy Glober
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摘要

背景/目的:机构间转运是现代医疗保健综合系统中不可或缺的一部分。许多被转运的病人都是老年人,这是一个特别脆弱的病人群体。不幸的是,机构间转运可能导致转运过程中的不适、与家人和家庭距离的增加、救护车费用的增加以及转运过程中发生意外的风险。方法:为了更好地了解老年人在医院间转运之前、期间和之后的经历,我们在接收医院的床边对患者及其护理人员进行了认知访谈。访谈中使用了一套标准问题来评估医院间转运过程的多个方面,包括转运医院的同意程序、转运经验以及转运带来的利益/伤害感知。结果:21 名患者和 14 名护理人员接受了本研究的访谈,在整个访谈过程中有五个主题。这些主题包括:转院决定中缺乏参与感、对接收医院的期望落空,以及对卫理公会医院等创伤中心的更大信任。结论:我们的访谈表明,更有必要在转院时征得转送医院的全面同意,讨论医院间转院的实际结果和预期风险。有了这些对话,患者及其护理人员就有能力对其护理做出明智的决定,并可能对所接受的护理更加满意,同时了解治疗期间的预期情况。
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Older Adults and their Experience with Interfacility Transfer
Background/Objective:Interfacility transfers are an integral part of integrated systems of care in modern healthcare. Many transferred patients are older adults, a particularly vulnerable patient population. Unfortunately, interfacility transfers can result in discomfort during the transport, increased distance from family and home, a significant bill for the ambulance ride, and risk of an accident occurring during transport. Methods:To better understand the experiences of older adults before, during, and after interfacility transfer, cognitive interviews were performed with patients and their caregivers at the bedside of the receiving hospital. A standard set of questions was used to assess multiple aspects of the interfacility transfer process including the consent process at the sending hospital, experience with the transfer, and perceived benefits/harms resulting from the transfer. Results:21 patients and 14 caregivers were interviewed in this study and five themes were present throughout these conversations. These themes included, a perceived lack of participation in the decision to be transferred, failed expectations at the receiving hospital, and greater trust in trauma centers like Methodist Hospital. Conclusion:Our interviews demonstrate a greater need for thorough consent for transfer at sending hospitals discussing the realistic outcomes and risks that can be expected from interfacility transfer. With these conversations patients and their caregivers can be empowered to make informed decisions about their care and will likely be more satisfied with the care that they receive and know what to expect during their treatment.
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