BACKGROUND hospital admissions of residents from nursing homes often lead to delirium, infections, mortality and reduced functional capacity. We initiated a new service, 'emergency department-based acute care service', maintained by consultants from an emergency department (ED) moving emergency care from the hospitals into nursing homes. OBJECTIVE this study explored healthcare professionals' experiences with this service. DESIGN qualitative semi-structured focus group discussions. INTERVENTION/SETTING the new service provides acute on-site evaluation and treatment to nursing home residents following calls to the emergency dispatch centre. METHODS we conducted focus groups with general practitioners, prehospital personnel, municipal acute care nurses, ED staff and nursing home staff. The analysis was performed using the iterative and explorative approach, 'systematic text condensation'. RESULTS the participants considered the service as a meaningful and appropriate alternative to hospital admission, as the treatment can be tailored to meet the residents' wishes and daily capabilities. This was experienced to promote dignity for the residents by reducing unnecessary transfers to the ED and the residents could remain in familiar surroundings with staff who knew their habitual behaviour and history. The nursing home staff contributed valuable information to the ED consultants' decision-making. The service made it possible to base the decision-making on complete patient pictures, as the ED consultants had the time to get to understand the residents. CONCLUSION acute care at nursing homes provides an alternative to routine admissions to hospitals and enables healthcare professionals to provide more dignity in the care of nursing home residents.

中文翻译：

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医疗保健专业人员在疗养院内进行急诊科急性护理的经验。

背景技术来自疗养院的居民入院通常会导致精神错乱、感染、死亡和功能下降。我们启动了一项新服务，即“基于急诊科的急性护理服务”，由急诊科 (ED) 的顾问维护，将急诊护理从医院转移到疗养院。目的 本研究探讨了医疗保健专业人员对这项服务的体验。设计定性的半结构化焦点小组讨论。干预/设置 接到紧急调度中心的电话后，新服务可为疗养院居民提供紧急现场评估和治疗。方法 我们与全科医生、院前人员、市政急症护理护士、急诊部工作人员和疗养院工作人员进行了焦点小组讨论。分析是使用迭代和探索性方法“系统文本压缩”进行的。结果 参与者认为该服务是一种有意义且适当的住院替代方案，因为可以根据居民的意愿和日常能力量身定制治疗。这样做是为了通过减少不必要的急诊转诊来提升居民的尊严，并且居民可以与了解他们的习惯行为和病史的工作人员一起留在熟悉的环境中。疗养院工作人员为急诊顾问的决策提供了宝贵的信息。该服务使得根据完整的患者照片做出决策成为可能，因为 ED 顾问有时间了解居民。