Palliative virtual wards: a cross-sectional UK survey.

IF 2 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Hannah Lucy May-Miller, Debra Swann
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引用次数: 0

Abstract

Objective: Various providers have piloted palliative virtual wards in the past 4 years. This survey provides the first aggregated data from across the UK.

Method: A cross-sectional online survey distributed to UK palliative care providers using a multilevel, snowballing methodology.

Results: 86 responses were received, with responses from 22 palliative virtual wards. All services who responded support patients with unstable palliative symptoms who would otherwise need hospital or hospice admission (100%). Many provide step-down support from hospital (72%) or the emergency department (69%).Services rely on daily specialist nurse and consultant input. A few have regular input from therapists (23%) and pharmacists (17%), which is reported as valuable. Most recruited additional staff (65%). Providers use telephone contact (100%) and face-to-face contact (93%). Fewer use video consultations (69%) and remote-monitoring technology (15%).75% of services rely on charitable funding and two virtual wards have closed due to lack of funds.Palliative virtual ward professionals report that they reduce hospital admissions, facilitate patient choice and provide support for patients' loved ones.

Conclusions: Palliative virtual wards are increasing in number: 25% of survey respondents are considering launching one. This survey details varied models of care and reports positive outcomes for patients, carers and staff. These services resemble frailty virtual wards with an emphasis on face-to-face rather than technology-enabled care. Integrated services within a wider virtual ward show promise but are currently in the minority.Further research is needed into the comparative benefits of a palliative virtual ward model over standard care.

姑息虚拟病房:英国横断面调查。
目的:在过去的4年里,不同的医疗服务提供者试点了姑息虚拟病房。这项调查首次提供了来自英国各地的汇总数据。方法:一个横断面的在线调查分发给英国姑息治疗提供者使用多层次,滚雪球的方法。结果:共收到86份反馈,其中22份来自姑息治疗虚拟病房。所有回应的服务机构都支持有不稳定缓和症状的患者,否则这些患者将需要住院或临终关怀(100%)。许多人从医院(72%)或急诊科(69%)提供后续支持。服务依赖于每日专科护士和咨询顾问的投入。少数人定期从治疗师(23%)和药剂师(17%)那里获得意见,这被认为是有价值的。大多数聘用额外工作人员(65%)。提供者使用电话联系(100%)和面对面联系(93%)。较少使用视频咨询(69%)和远程监控技术(15%)。75%的服务依赖于慈善资金,两个虚拟病房由于缺乏资金而关闭。姑息虚拟病房专业人员报告说,他们减少了住院人数,促进了患者的选择,并为患者的亲人提供了支持。结论:姑息治疗虚拟病房的数量正在增加:25%的受访者正在考虑推出姑息治疗虚拟病房。这项调查详细介绍了各种护理模式,并报告了患者、护理人员和工作人员的积极结果。这些服务类似于虚弱的虚拟病房,强调面对面的护理,而不是技术支持的护理。更广泛的虚拟病房内的综合服务显示出希望,但目前还属于少数。需要进一步研究姑息虚拟病房模式相对于标准护理的比较效益。
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来源期刊
BMJ Supportive & Palliative Care
BMJ Supportive & Palliative Care Medicine-Medicine (miscellaneous)
CiteScore
4.60
自引率
7.40%
发文量
170
期刊介绍: Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance. We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication. In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.
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