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Paramedic information needs in end-of-life care: a qualitative interview study exploring access to a shared electronic record as a potential solution.
BMC Palliative Care ( IF 2.5 ) Pub Date : 2019-12-05 , DOI: 10.1186/s12904-019-0498-2
Rebecca Patterson 1 , Holly Standing 2 , Mark Lee 3 , Sonia Dalkin 4 , Monique Lhussier 4 , Catherine Exley 5 , Katie Brittain 2
Affiliation  

BACKGROUND Limited access to, understanding of, and trust in paper-based patient information is a key factor influencing paramedic decisions to transfer patients nearing end-of-life to hospital. Practical solutions to this problem are rarely examined in research. This paper explores the extent to which access to, and quality of, patient information affects the care paramedics provide to patients nearing end-of-life, and their views on a shared electronic record as a means of accessing up-to-date patient information. METHOD Semi-structured interviews with paramedics (n = 10) based in the north of England, drawn from a group of health and social care professionals (n = 61) participating in a study exploring data recording and sharing practices in end-of-life care. Data were analysed using thematic analysis. RESULTS Two key themes were identified regarding paramedic views of patient information: 1) access to information on patients nearing end-of-life, and 2) views on the proposed EPaCCS. Paramedics reported they are typically unable to access up-to-date patient information, particularly advance care planning documents, and consequently often feel they have little option but to actively treat and transport patients to hospital - a decision not always appropriate for, or desired by, the patient. While paramedics acknowledged a shared electronic record (such as EPaCCs) could support them to provide community-based care where desired and appropriate, numerous practical and technical issues must be overcome to ensure the successful implementation of such a record. CONCLUSIONS Access to up-to-date patient information is a barrier to paramedics delivering appropriate end-of-life care. Current approaches to information recording are often inconsistent, inaccurate, and inaccessible to paramedics. Whilst a shared electronic record may provide paramedics with greater and timelier access to patient information, meaning they are better able to facilitate community-based care, this is only one of a series of improvements required to enable this to become routine practice.

中文翻译:

临终护理中的医护人员信息需求:一项定性访谈研究,探讨访问共享电子记录作为一种可能的解决方案。

背景技术对纸质患者信息的有限访问,理解和信任是影响护理人员将临终患者转移到医院的决策的关键因素。在研究中很少研究针对该问题的实际解决方案。本文探讨了患者信息的访问和质量在多大程度上影响护理人员为临终患者提供的护理,以及他们对共享电子记录的看法,以此作为获取最新患者信息的一种手段。方法对来自英格兰北部的医护人员(n = 10)进行半结构式访谈,该访谈来自一组参与研究寿命结束时数据记录和共享实践的研究的健康和社会护理专业人员(n = 61)关心。使用主题分析对数据进行分析。结果确定了与患者信息的护理人员观点有关的两个关键主题:1)访问接近寿命终止期的患者信息,以及2)对提议的EPaCCS观点。医护人员报告说,他们通常无法访问最新的患者信息,尤其是事前护理计划文档,因此常常觉得他们别无选择,只能积极地治疗患者并将其运送到医院-这项决定并不总是适合或希望患者做出。 , 患者。医护人员承认共享的电子记录(例如EPaCC)可以支持他们在需要和适当的地方提供基于社区的护理,但是必须克服许多实际和技术问题,以确保成功实施这样的记录。结论获得最新的患者信息是医护人员提供适当的临终护理的障碍。当前的信息记录方法通常不一致,不准确且医护人员无法访问。尽管共享的电子记录可以为医护人员提供更多,更及时的患者信息访问渠道,这意味着他们可以更好地促进基于社区的护理,但这只是使这种护理成为常规所需要的一系列改进之一。
更新日期:2019-12-05
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