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远程医疗培训手册和准则 -- 通过从医学专业值得信赖 1985


FAQ Adult & 儿科远程医疗指南


 关于成人的常见问题 & 儿科远程医疗指南

什么是独特的关于这些准则? Several features make these guidelines unique; 它们是第一个也是唯一的纸质指南,:

  • 利用 5-Level Triage处理方式  自 1995
  • 是针对年龄的: Infant-child (分娩- 6 年), 学龄 (6 -18 年) 和成年人口
  • applicable “round the clock” — 24/7/365 — not just Office Hours ( 9-5 M-F)
  • are designed for trained, 有经验的临床医师 to use
  • are based on AAACN Standards and others
  • utilize a robust 5-level triage 通用准则
  • are patient-centered using 5th-8th grade literacy level for ease of communication and for application to the broadest population
  • may serve as a template for your facility’s telehealth guidelines
  • can serve as a training tool for estimating the urgency of common presenting symptoms
  • Can serve as an on-site triage tool as well as for telehealth remote encounters.

医学研究所建议开发系统, “可以很容易地做正确的事”.  The Clinical Task Force worked tirelessly to make these Telehealth Guidelines user friendly, 标准- 和循证, transparent. Each volume addresses clinical presentation, possible diagnoses, dispositions and treatments unique to three age-based groups.

45-50 Guidelines are information-packed, concise and structured to facilitate rapid interactions are quick and easy to use.  Each volume addresses 1500 可能的诊断及以上 500 信息主题, making them the most comprehensive products on the market.

这是一个5-级别分类方法?  自 1995, 吨hese telehealth guidelines have employed a 5-Level Triage approach, 前期工作 曼彻斯特分类集团 和5层急诊分类.   The five levels are: life threatening, 紧急, 急, acute and non-acute, each with a definition, time frame and place for patients to be seen.  这些准则,en “help patients to get to the Right Place, at the Right Time, for the Right Reason”. TM

Why is clinical training important? 无论使用哪种准则 — 无论是电子或纸基,  临床医生必须在​​电话分流培训 (malpractice avoidance, 评定, 通讯, documentation skills, in medical decision making, 批判性思维, 护理过程, metacognition and more) — 五个基本系统部件中的一个.  软件培训并不能取代临床决策培训.  女士. 惠勒提供电话指导原则要求临床培训, on-site and on-line.

是怎样组织的指导方针?  The Institute of Medicine recommends developing a system — 结构和工艺 — that are user friendly and transparent and “可以很容易地做正确的事”.  These guidelines are organized designed with those goals in mind.

Three volumes address Pediatric (Infant-Child and School Age) and Adult age groups. We organized symptoms the way patiients typically present themby site, 解剖 — 腹部, 后面, 胸部, 耳, eye, 颈部, 等等).

We organized them alphabetically to facilitate the search. This unique feature enables nurses to quickly locate the correct guidelines. 这种简单但非常有效的设计通过使用从症状部位开始的外行术语简化了“搜索”过程, 其次是相关症状. 例如, 当患者呈现 “眼睛问题”, 是否 — 异物, 创伤, 隐形眼镜的问题, 疼痛, 视力问题, 红眼, 视力突然丧失, 或放 — 护士用眼问题指导方针开始, 从而消除耗时和令人沮丧的搜索,通过数百种不同的协议“正确”一.

在一个算法格式的准则?   We designed a hybrid composed of a broad algorithm and pattern matching approach. 通过Vimla帕特尔进行的一项研究 (1995) 已经发现,电话分诊护士使用上下文, 或模式识别做出医疗决定. Pattern recognition approaches mimic the way the human brain naturally solves problems. 从而, 我们基于这样的设计对半算法和模式识别模型的组合.

一些专家认为,严格的算法是医疗决策中更科学的方法, 至今, this approach is very diagnostic and deterministic. To date there are no outcome studies that demonstrate that algorithms result in safer outcomes when compared with pattern elicitation, recognition and matching. Some experts feel that algorithms are a form of “automated thinking”– and unsuitable for the assessment of invisible patients.

在所有设置的有用这些准则? They are suitable for the broadest range of settings:   临床呼叫中心, 保健组织, 集团的做法, 学校护士, 办公室, 学生健康中心, 县级医院或私家医院, 社区诊所, 急诊科, 公共卫生诊所或家庭健康场所.  它们可用于急诊室的现场分类。, 紧急护理, 诊所, Office, School or Student Health settings.

 这些电话分类指南是否包括妇女健康?  如果您查看目录 小心, 你会看到,妇女的健康初级保健为成人和青少年被透了解决. 核心妇女健康协议解决常见的症状和信息问题,如: 滥用: 性和物理/长老; 乳房问题, 母乳喂养的问题, 情绪问题, 产后的问题和顾虑 (不适), 怀孕的问题和顾虑 (不适), 泌尿问题, 阴道问题与出血, 和妇女健康问题: 节育和更年期的关注和常见问题.

什么是这些准则的基本假设?   我们的成人和儿童指南是决策支持工具, 不是决策工具 (algorithms).  就像医生的常规命令一样, pattern-recognition guidelines remind users of information they may have once known, but may have forgotten. Trained, experienced clinicians are autonomous professionals, 和最终的决策者, not the protocols. Algorithms rely on “Automated Reasoning”requires accurate, discrete patient information (lab results, physical exam).  它们是确定性和诊断性的; intended to establish a cause for symptoms.

这些可用于研究电话分流指引  Ms Wheeler welcomes the use of these guidelines in any evidence based research or comparative studies. 请通过与她联系 415 453 8382 讨论这个选项.

Learn more about the Task Force who developed the Guidelines

电话分流指引: 补充资料

成人远程医疗指南 (年龄 18+)

儿科远程医疗指南(学龄: 6 -18 岁月)

儿科远程医疗指南(婴幼儿,儿童: 从出生到 6 岁月)

Universal Telehealth Guideline

“系统,帮助临床医生 “获取病人到合适的位置, at the Right Time, for the Right Reason” TM


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