大流行病中肿瘤学和姑息关怀中的跨学科预先护理计划:最佳实践实施项目。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Felix Muehlensiepen, Henrikje Stanze, Susann May, Kerstin Stahlhut, Carolin Helm, Hassan Tarek Hakam, Małgorzata M Bała, Tina Poklepović Peričić, Tereza Vrbová, Jitka Klugarova, Robert Prill
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引用次数: 0

摘要

导言:预先护理计划(ACP)可确保患者获得符合其价值观、目标和偏好的医疗护理,尤其是在严重慢性疾病的临终决定方面:本项目旨在 COVID-19 大流行期间,在德国柏林附近的一家中型医院的肿瘤学和姑息治疗中引入并推广以证据为基础的 ACP:该项目以 JBI 证据实施框架为指导,采用混合方法审计周期。通过定性访谈和研讨会的形式,对该医院参与肿瘤学和姑息治疗的所有医疗学科的代表进行了基线审核。审计结果与八项最佳实践建议进行了比较。然后,针对参与 ACP 实践的主要利益相关者实施了有针对性的策略。最后,在后续审计中使用了半定量问卷,参与人员与基线审计相同:结果:基线审计显示,人们对 ACP 概念的熟悉程度较高。然而,医护人员对 ACP 缺乏统一的定义和理解,导致任务分配缺乏协调。后续审计显示,ACP 的教育和培训(标准 1:50% 至 100%)以及促进 ACP 对话的组织支持(标准 3:87.5% 至 100%)均有所改善。其他审核标准的符合率保持不变:临床教育和基于团队的流程分析可促进肿瘤和姑息治疗机构各学科实施 ACP。然而,由于 COVID-19 大流行,该项目未能成功实施临床流程和最佳实践 ACP 的持久变革。这样的努力需要大量的资源和时间,而在大流行期间这两者都受到了限制。西班牙文摘要:http://links.lww.com/IJEBH/A236。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cross-disciplinary advance care planning in oncology and palliative care amidst a pandemic: a best practice implementation project.

Introduction: Advance care planning (ACP) ensures that patients receive medical care aligned with their values, goals, and preferences, especially regarding end-of-life decisions in serious chronic illnesses.

Objective: This project aimed to introduce and promote evidence-based ACP in oncology and palliative care at a midsized hospital near Berlin, Germany, during the COVID-19 pandemic.

Methods: This project was guided by the JBI Evidence Implementation Framework and used a mixed methods audit cycle. A baseline audit was conducted using qualitative interviews and workshops with representatives from all the health care disciplines involved in oncology and palliative care at the hospital. The findings were compared with eight best practice recommendations. Targeted strategies aimed at the key stakeholders involved in ACP practice were then implemented. Finally, a semi-quantitative questionnaire was used in a follow-up audit with the same participants as in the baseline audit.

Results: The baseline audit revealed a high level of familiarity with the concept of ACP. However, there was a lack of a uniformly accepted definition and understanding of ACP among the health care professionals, leading to a lack of coordination in task distribution. The follow-up audit revealed improvements with regard to education and training in ACP (Criterion 1: 50% to 100%) and organizational support to facilitate ACP conversations (Criterion 3: 87.5% to 100%). Other audit criteria compliance rates remained unchanged.

Conclusion: Clinical education and team-based process analysis can facilitate ACP implementation across disciplines in oncology and palliative care facilities. However, the project did not succeed in implementing lasting changes in clinical processes and best practice ACP due to the COVID-19 pandemic. Such an endeavor would demand considerable resources and time, both of which were constrained during the pandemic.

Spanish abstract: http://links.lww.com/IJEBH/A236.

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CiteScore
3.20
自引率
13.00%
发文量
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