■精神状态恶化给医疗保健带来了重大挑战,影响患者和提供者。精神错乱和躁动等症状会导致住院时间延长,增加成本,以及限制性干预措施的使用。尽管流行,对于在急症医院环境中管理心理状态恶化的有效做法缺乏共识。为了解决这个差距,快速反应团队模型已被提出作为潜在的干预措施,旨在提供早期识别和有针对性的干预措施。
■基于现实主义的评估步骤,首先,最初的计划理论是为了理解干预背后的逻辑而制定的。第二,文献综合确定了上下文的经验证据,机制,和成果要素,完善最初的理论。在第三步,数据将使用定性方法收集,如实地观察和访谈,以及定量方法,如员工调查,电子病历的审计,并分析了心理状态恶化的事件记录。分析此数据会通知上下文的配置,机制,和结果。第五步,配置是综合的,呈现精致,循证计划理论。
■本研究通过评估快速反应模型在急性医院环境中管理精神状态恶化的有效性来解决知识差距。现实主义原则指导因果机制的探索及其与具体实施环境的相互作用。目的是确定什么是有效的,为谁,在什么情况下,旨在管理恶化,减少限制性干预措施,并通过实施积极的护理模式来增强患者和工作人员的体验。这些发现有助于在医院环境中管理精神状态恶化的循证方法,为医疗保健这一关键领域的政策和实践提供信息。
UNASSIGNED: Mental state deterioration poses significant challenges in healthcare, impacting patients and providers. Symptoms like confusion and agitation can lead to prolonged hospital stays, increased costs, and the use of restrictive interventions. Despite its prevalence, there\'s a lack of consensus on effective practices for managing mental state deterioration in acute hospital settings. To address this gap, a rapid response team model has been proposed as a potential intervention, aiming to provide early identification and targeted interventions.
UNASSIGNED: Based on realist evaluation steps, first, initial program theories are formulated to understand the logic behind the intervention. Second, literature synthesis identifies empirical evidence on contexts, mechanisms, and outcomes elements, refining initial theories. During the third step, data will be collected using qualitative methods such as field observations and interviews, as well as quantitative methods such as surveys of the staff, audits of electronic medical records, and analysis of incident records of mental state deterioration. Analysing this data informs configurations of contexts, mechanisms, and outcomes. In the fifth step, the configurations are synthesised, presenting refined, evidence-informed program theories.
UNASSIGNED: This study addresses the knowledge gap by evaluating the rapid response model\'s effectiveness in managing mental state deterioration in acute hospital settings. Realist principles guide the exploration of causal mechanisms and their interaction with specific implementation contexts. The objective is to identify what works, for whom, and under what circumstances, aiming to manage deterioration, reduce restrictive interventions, and enhance the experience for patients and staff by implementing a proactive model of care. The findings contribute to evidence-based approaches for managing mental state deterioration in hospital settings, informing policy and practice in this crucial area of healthcare.