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首页> 外文期刊>Prehospital emergency care >The effect of a quality improvement feedback loop on paramedic-initiated nontransport of elderly patients.
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The effect of a quality improvement feedback loop on paramedic-initiated nontransport of elderly patients.

机译：质量改善反馈回路对护理人员启动的老年患者非运输的影响。

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OBJECTIVE: To examine the effect of a paramedic educational program and quality improvement feedback loop on paramedic-initiated nontransport of patients 65 years of age and older. METHODS: Prospective observational study. Patients 65 years of age and older who were evaluated but not transported by paramedics were contacted by telephone within two weeks of emergency medical services (EMS) contact and asked: 1) whether the patient sought medical help within 24 hours after contact; 2) whether the patient was admitted to a hospital and, if so, what was the diagnosis; 3) who was responsible for the nontransport decision (patient, paramedic, or mutual); and 4) how satisfied the patient was with the EMS service. After six weeks of data collection, the results were presented in a nonjudgmental fashion to the paramedics. After this intervention, the data collection continued for another five weeks without the paramedics' knowledge. RESULTS: After the intervention, the overall nontransport rate remained constant (11.5% vs. 10.7%). The percentage of patients seeking further medical attention within 24 hours also remained constant (37.1% vs. 33.9%). The percentage of patients who required hospitalization within 24 hours of the nontransport declined from 12.6% to 6.4%. The percentage of patients who refused ambulance transportation by paramedics declined from 9.3% to 3.7%. Overall satisfaction level rose from 94.7% to 100%. CONCLUSION: When paramedics were provided with objective feedback regarding outcome of patients not transported, the paramedic-initiated nontransportation and delayed hospitalization rates decreased, and the patient satisfaction level rose to 100%.
机译：目的：研究护理人员教育计划和质量改进反馈回路对65岁及65岁以上患者因护理人员启动的非运输方式的影响。方法：前瞻性观察研究。在接受紧急医疗服务（EMS）的两周内通过电话联系了接受评估但未通过护理人员运送的65岁及65岁以上的患者，并询问：1）患者是否在联系后24小时内寻求医疗帮助; 2）患者是否入院，如果诊断，该如何诊断？ 3）谁负责非运输决策（患者，医护人员或相互）; 4）患者对EMS服务的满意度。经过六周的数据收集，结果以非判断性的方式呈现给护理人员。经过这种干预，在护理人员不知情的情况下，数据收集又继续进行了五个星期。结果：干预后，总体非运输率保持不变（11.5％对10.7％）。在24小时内寻求进一步医疗护理的患者百分比也保持不变（37.1％对33.9％）。非运输后24小时内需要住院治疗的患者比例从12.6％降至6.4％。医护人员拒绝救护车运送的患者比例从9.3％下降到3.7％。总体满意度从94.7％提高到100％。结论：当医护人员获得有关未转运患者结局的客观反馈时，由医护人员启动的非转运和延迟住院率下降，患者满意度提高到100％。

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