Exploring factors affecting the timely transition of ventilator assisted individuals in Ontario from acute to long-term care: Perspectives of healthcare professionals.

0 CRITICAL CARE MEDICINE
Canadian Journal of Respiratory Therapy Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI:10.29390/001c.89103
Anne-Marie Selzler, Leanna Lee, Dina Brooks, Raj Kohli, Louise Rose, Roger Goldstein
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引用次数: 0

Abstract

Rationale: Ventilator Assisted Individuals (VAIs) frequently remain in intensive care units (ICUs) for a prolonged period once clinically stable due to a lack of transition options. These VAIs occupy ICU beds and resources that patients with more acute needs could better utilize. Moreover, VAIs experience improved outcomes and quality of life in long-term and community-based environments.

Objective: To better understand the perspectives of healthcare providers (HCPs) working in an Ontario ICU regarding barriers and facilitators to referral and transition of VAIs from the ICU to a long-term setting.

Methods: We conducted semi-structured interviews with ten healthcare providers involved in VAI transitions.

Main results: Perceived barriers included long wait times for long-term care settings, insufficient bed availability at discharge locations, medical complexity of patients, long waitlists, and a lack of transparency of waitlists. Facilitators included strong partnerships and trusting relationships between referring and discharge locations, a centralized referral system, and utilization of community partnerships across care sectors.

Conclusions: Insufficient resourcing of long-term care is a key barrier to transitioning VAIs from ICU to long-term settings; strong partnerships across care sectors are a facilitator. System-level approaches, such as a single-streamlined referral system, are needed to address key barriers to timely transition.

探讨影响安大略省呼吸机辅助患者从急性护理及时过渡到长期护理的因素:医疗保健专业人员的观点。
理由:呼吸机辅助个体(VAI)由于缺乏过渡选择,一旦临床稳定,经常长期留在重症监护室(ICU)。这些VAI占用了ICU床位和资源,有更迫切需求的患者可以更好地利用这些床位和资源。此外,VAI在长期和社区环境中的结果和生活质量有所改善。目的:更好地了解在安大略省重症监护室工作的医疗保健提供者(HCP)对VAI从重症监护室转诊和过渡到长期环境的障碍和促进因素的看法。方法:我们对参与VAI过渡的10名医疗保健提供者进行了半结构化访谈。主要结果:感知到的障碍包括长期护理环境的等待时间长、出院地点的床位不足、患者的医疗复杂性、等待名单长以及等待名单缺乏透明度。促进者包括转诊和出院地点之间的强大伙伴关系和信任关系、集中转诊系统以及利用护理部门的社区伙伴关系。结论:长期护理资源不足是VAI从ICU过渡到长期环境的关键障碍;各护理部门之间强有力的伙伴关系是一个促进因素。需要采取系统一级的方法,如单一的简化转诊系统,以解决及时过渡的关键障碍。
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来源期刊
Canadian Journal of Respiratory Therapy
Canadian Journal of Respiratory Therapy Health Professions-Health Professions (miscellaneous)
CiteScore
2.00
自引率
0.00%
发文量
34
期刊介绍: The CJRT is published four times a year and represents the interests of respiratory therapists nationally and internationally. The CJRT has been redesigned to act as an educational dissemination tool. The CJRT encourages submission of original articles, papers, commentaries, case studies, literature reviews and directed reading papers. Submissions can be sent to Rita Hansen.
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