家庭医疗电话分诊:分类错误及相关因素

Lina S. Ocampo, Catalina Bernal, Johanna M. Vanegas
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引用次数: 0

摘要

目的了解家庭护理电话分诊中分类错误的发生频率及其相关因素。设计横断面观察性研究。一个家庭护理服务的管理中心。哥伦比亚麦德林。参与者:监管中心的医护人员。干预措施评估2020年1 - 6月援助人员接听的电话记录。主要测量方法:电话呼叫和救援人员的分类误差频率和特征。采用广义估计方程模型对影响分类误差的因素进行了分析。结果共分析260份电话记录,其中分类错误占15.4% (n = 40),其中对患者分类错误占53.7%(分诊不足)。护理人员(n = 58)中位年龄为26.5岁(IQR 23-31),女性占69% (n = 40)。分类错误率较高的是患者以外的人所要求的服务(75%;N = 30)和在夜间拨打的电话(42.5%;N = 17)。在多因素分析中,发现患者主诉与分类错误之间存在相关性(OR: 2.42, CI95%: 1.06-5.53)。结论初级保健中分诊不足会造成延误,增加并发症的发生风险。为避免电话分诊过程中的错误,并对患者和护理质量产生积极影响,对医疗保健人员实施培训策略非常重要。
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Triaje telefónico en medicina domiciliaria: error de clasificación y factores asociados

Objective

To determine the frequency of classification error and its associated factors during telephone triage in a home care service.

Design

Cross-sectional observational study.

Site

Regulatory center of a home care service. Medellin Colombia.

Participants

Health care staff of the regulatory center.

Interventions

The records of the telephone calls answered by the assistance personnel during January to June of the year 2020 were evaluated.

Main measurements

Frequency of classification error and characteristics of the telephone call and of the assistance personnel. The factors associated with the classification error were analyzed using a model of generalized estimating equations (GEE).

Results

260 telephone records were analyzed, of which 15.4% (n = 40) presented a classification error, 53.7% of them against the patient (undertriage). Regarding the care staff (n = 58), the median age was 26.5 years (IQR 23-31) and 69% (n = 40) were women. A higher percentage of classification error was found in services requested by people other than the patient (75%; n = 30) and in calls made during the night (42.5%; n = 17). In the multivariate analysis, an association was observed between the patient's complaint and classification error (OR: 2.42, CI95% 1.06-5.53).

Conclusions

Undertriage can generate delays and increase the risk of complications in primary care. It is important to implement training strategies for 4 healthcare personnel to avoid errors during telephone triage and generate a positive impact on patients and the quality of care.

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来源期刊
Atencion Primaria Practica
Atencion Primaria Practica Medicine-Family Practice
CiteScore
0.30
自引率
0.00%
发文量
40
审稿时长
24 days
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