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首页> 外文期刊>International Journal of Environmental Research and Public Health >Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
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Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa

机译：遵守专门烧伤中心的入院和患者管理推荐标准：以南非开普敦的红十字战争纪念儿童医院为例

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Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. All patients admitted to the centre during the winters of 2011–2015 ( n = 1165) were included. The patient files were scrutinized to clarify whether the referral criteria in place were identified (seven in total) and to compile data on patient and injury characteristics. A case was defined as adherent to the criteria when at least one criterion was fulfilled and adherence was expressed as a percentage with 95% confidence intervals, for all years aggregated as well as by year and by patient or injury characteristics. The association between adherence to any individual criterion and hospital care (surgery or longer length of stay) was measured using logistic regressions. The overall adherence was 93.4% (100% among children under 2 years of age and 86% among the others) and it did not vary remarkably over time. The two criteria of “injury sustained at a specific anatomical site” (85.2%) and “young age” (51.9%) were those most often identified. Children aged 2 years or older were more likely to undergo surgery or to stay longer than those of young age (although a referral criterion) and so were those with higher injury severity (a referral criterion). In this specialized paediatric burns centre, children are admitted mainly according to the guidelines. However, given the high prevalence of paediatric burns in the region and the limited resources at the burns centre, adherence to the guidelines need to be further studied at all healthcare levels in the province.
机译：烧伤护理转诊指南旨在协助患者转院和入选专门科室的决策。然而，关于它们被追踪的密切程度以及它们是否与患者护理联系在一起，人们所知甚少。这是当前研究的目标，重点是南非开普敦红十字战争纪念儿童医院的小儿烧伤中心。纳入了2011–2015年冬季（n = 1165）入院的所有患者。仔细检查患者档案，以澄清是否确定了适当的推荐标准（总共七个），并汇编了有关患者和伤害特征的数据。当满足至少一个条件且所有年份合计以及年份和患者或伤害特征时，将符合至少一个条件且依从性表示为具有95％置信区间的百分比表示为病例。使用logistic回归分析了对任何个人标准的依从性与医院护理（手术或更长的住院时间）之间的关联。总体依从性为93.4％（2岁以下儿童为100％，其他儿童为86％），并且随时间变化不明显。最常被识别的两个标准是“在特定解剖部位持续受伤”（85.2％）和“年轻”（51.9％）。 2岁或2岁以上的儿童比年幼的儿童更有可能接受手术或住院更长的时间（尽管有转诊标准），而受伤严重程度较高的儿童（有转诊标准）也是如此。在这个专门的小儿烧伤中心，主要是根据指南接纳儿童的。但是，鉴于该地区小儿烧伤的患病率很高，而且烧伤中心的资源有限，因此需要对该省所有医疗保健水平进一步研究遵守指南的情况。

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