了解在 COVID-19 大流行期间急诊科临床医生对创新信息的吸收情况

IF 1.6 Q2 EMERGENCY MEDICINE
Nabeel Qureshi MPH, MPhil, Shreya S. Huilgol BA, Carl T. Berdahl MD, MS, Catherine C. Cohen PhD, RN, Peter Mendel PhD, Shira H. Fischer MD, PhD
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引用次数: 0

摘要

目的 在 COVID-19 大流行的早期,人们对如何管理病人知之甚少,但急诊科(ED)的临床医生必须决定采用哪些治疗方法和护理流程。我们的目的是描述急诊科临床医生如何了解创新,以及他们在大流行期间如何评估创新的可信度。 方法 我们有目的地从医院急诊室抽取临床医生,与急诊室临床医生和员工进行焦点小组讨论。我们采用归纳法和演绎法对记录誊本进行了主题分析。 结果 我们与来自全美八家急诊室的临床医生进行了焦点小组讨论。我们发现,样本中的急诊室临床医生依靠朋友、同事或部门和机构领导来获取创新信息。如果社交媒体上的信息来源可信,他们就会使用,但不会直接从专业协会寻求信息。临床医生报告了在大流行期间获取可靠信息所面临的一系列挑战,包括信息环境混乱且不断变化、各临床机构的政策不一致或与临床知识相冲突、病人数量多、担心伤害病人以及信息不及时。促进因素包括与经验丰富、值得信赖的同事和领导接触,以及在多个急诊室实习。 结论 与会者认为,在大流行病的早期阶段,有关护理创新的主要信息来源是轶事证据、机构实践和口口相传,而不是同行评议的证据和专业协会的交流。这些结果表明,在快速出现的公共卫生突发事件中,建立值得信赖的地方机制和更广泛的网络为一线临床医生识别和审核信息非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Understanding uptake of information about innovations among emergency department clinicians during the COVID-19 pandemic

Understanding uptake of information about innovations among emergency department clinicians during the COVID-19 pandemic

Objectives

Early in the COVID-19 pandemic, little was known about managing sick patients, but emergency department (ED) clinicians had to decide which treatments and care processes to adopt. Our objective was to describe how ED clinicians learned about innovations and how they assessed them for credibility during the pandemic.

Methods

We purposively sampled clinicians from hospital-based EDs to conduct focus groups with ED clinicians and staff. We used both inductive and deductive approaches to conduct thematic analysis of transcripts.

Results

We conducted focus groups with clinicians from eight EDs across the United States. We found that ED clinicians in our sample relied on friends and colleagues or departmental and institutional leadership for information on innovations. They used social media sources when they came from credible accounts but did not directly seek information from professional societies. Clinicians reported a range of challenges to obtain credible information during the pandemic, including a fractured and changing information environment, policies misaligned across clinical sites or that conflicted with clinical knowledge, high patient volume, fear of harming patients, and untimely information. Facilitators included access to experienced and trusted colleagues and leaders and practicing at multiple EDs.

Conclusion

Participants cited anecdotal evidence, institutional practice, and word-of-mouth—rather than peer-reviewed evidence and professional society communications—as their primary sources of information about care innovations during the early phases of the pandemic. These results underscore the importance of developing trusted local mechanisms and wider networks to identify and vet information for frontline clinicians during rapidly emerging public health emergencies.

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