在社区医院使用 ReSPECT 紧急护理和治疗计划:一项质量改进计划。

Christine Penhale, Catherine Evans, Lisa O'Hara, Lorraine Arnold
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引用次数: 0

摘要

背景:建议的紧急护理和治疗简要计划(ReSPECT)是一项护理计划,用于在患者无法做出贡献时指导紧急治疗。目的:实施、评估并嵌入 ReSPECT 对话,以改善非工作时间的患者安全,并支持患者及其家属的参与:方法:2022 年 5 月至 2023 年 9 月期间,在一个拥有 35 张病床的社区医院病房中,以正常化过程理论(NPT)为基础进行质量改进设计。组织优先事项、促进者和拥护者为计划提供支持。评估分析了 ReSPECT 计划、观察结果和后续焦点小组:一年来,ReSPECT 对话增加了 43%(从 23 名患者增加到 32 名患者),对话质量也有所提高(从 15/23 名记录了不尝试心肺复苏决定但未制定 ReSPECT 计划的患者增加到 32/35 名制定了个性化 ReSPECT 计划的患者):结论:ReSPECT可在社区医院实施,并由促进者和倡导者来实现和嵌入变革。该实施计划将为在社区医院病房中针对体弱多病的成年人进行更广泛的推广提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using the ReSPECT emergency care and treatment plan in a community hospital: a quality improvement initiative.

Background: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a care plan to guide emergency treatment when the person cannot contribute. ReSPECT is important in supporting adults at risk of decline.

Aim: To implement, evaluate and embed ReSPECT conversations to improve patient safety out of hours and support involvement of patients and their families.

Methods: A quality improvement design underpinned by normalisation process theory (NPT) undertaken in a 35-bed community hospital ward between May 2022 and September 2023. Organisational prioritisation, facilitators, and champions supported the plan. Evaluation analysed ReSPECT plans, observations and a follow-up focus group.

Results: ReSPECT conversations increased by 43% over 1 year (23 to 32 patients), and in quality (from 15/23 patients with a do not attempt cardiopulmonary resuscitation decision recorded and no ReSPECT plan to 32/35 with an individualised ReSPECT plan).

Conclusions: ReSPECT could be implemented in community hospitals with facilitators and champions to deliver and embed change. The implementation plan is informing wider rollout across community hospital wards for adults with frailty and multiple conditions.

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