英国为COVID-19确诊患者提供远程家庭监测服务的员工培训经验:一项混合方法研究

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES
Manbinder Sidhu, Holly Walton, Nadia Crellin, Jo Ellins, Lauren Herlitz, Ian Litchfield, Efthalia Massou, Sonila M Tomini, Cecilia Vindrola-Padros, Naomi J Fulop
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引用次数: 0

摘要

目标:2019冠状病毒病大流行期间推出的针对有快速恶化风险的患者的远程家庭监测服务对卫生人力具有重要影响。本研究探讨了英格兰医疗保健人员远程管理COVID-19患者的“工作”性质,如何支持他们提供这些新服务,以及影响为工作人员提供COVID-19远程家庭监测服务的因素。方法:我们在2020年11月至2021年7月期间对COVID-19远程家庭监测服务进行了快速混合方法评估,对来自英格兰28个站点的参与提供服务的工作人员(临床负责人、一线交付人员和参与数据收集和管理的人员)进行了有目的的抽样调查。我们还对17个地点的58名工作人员进行了访谈。数据收集和分析并行进行。我们使用专题分析来分析定性数据,而使用描述性统计来分析定量调查数据。结果:共有292名员工参与调查,回复率39%。我们发现,以前的远程监测经验在为COVID-19诊断患者提供类似服务方面有一些(尽管有限)益处。工作人员接受了一系列当地特定的培训和临床监督,以及定制的材料和资源。工作人员报告说,他们对使用自己的判断感到不确定,并依赖于寻求临床监督。从面对面服务到远程服务的转变,让一些一线服务人员重新思考他们的专业角色,以及他们对自己能力的信念。人们普遍认为,工作人员能够适应,获得新的技能和知识,他们表现出对继续照顾病人的承诺,尽管有报告说,他们有时在适应后的角色所附加的更多责任和责任方面遇到困难。结论:远程家庭监测模式可以在管理大量COVID-19患者和可能的一系列其他疾病中发挥重要作用。这种服务模式的成功提供取决于工作人员的能力和所接受培训的性质,以促进有效的护理和病人的参与。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Staff experiences of training and delivery of remote home monitoring services for patients diagnosed with COVID-19 in England: A mixed-methods study.

Objectives: Remote home monitoring services for patients at risk of rapid deterioration introduced during the COVID-19 pandemic had important implications for the health workforce. This study explored the nature of 'work' that health care staff in England undertook to manage patients with COVID-19 remotely, how they were supported to deliver these new services, and the factors that influenced delivery of COVID-19 remote home monitoring services for staff.

Methods: We conducted a rapid mixed-methods evaluation of COVID-19 remote home monitoring services during November 2020 to July 2021 using a cross-sectional survey of a purposive sample of staff involved in delivering the service (clinical leads, frontline delivery staff and those involved in data collection and management) from 28 sites across England. We also conducted interviews with 58 staff in a subsample of 17 sites. Data collection and analysis were carried out in parallel. We used thematic analysis to analyse qualitative data while quantitative survey data were analysed using descriptive statistics.

Results: A total of 292 staff responded to the surveys (39% response rate). We found that prior experience of remote monitoring had some, albeit limited benefit for delivering similar services for patients diagnosed with COVID-19. Staff received a range of locally specific training and clinical oversight along with bespoke materials and resources. Staff reported feeling uncertain about using their own judgement and being reliant on seeking clinical oversight. The experience of transitioning from face-to-face to remote service delivery led some frontline delivery staff to reconsider their professional role, as well as their beliefs around their own capabilities. There was a general perception of staff being able to adapt, acquire new skills and knowledge and they demonstrated a commitment to continuity of care for patients, although there were reports of struggling with the increased accountability and responsibility attached to their adapted roles at times.

Conclusions: Remote home monitoring models can play an important role in managing a large number of patients for COVID-19 and possibly a range of other conditions. Successful delivery of such service models depends on staff competency and the nature of training received to facilitate effective care and patient engagement.

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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
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