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Assessment of a Chief Complaint–Based Curriculum for Resident Education in Geriatric Emergency Medicine

机译:评估基于首席投诉的老年急诊医学驻院教育课程

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Introduction: We hypothesized that a geriatric chief complaint–based didactic curriculum would improve resident documentation of elderly patient care in the emergency department (ED). Methods: A geriatric chief complaint curriculum addressing the 3 most common chief complaints—abdominal pain, weakness, and falls—was developed and presented. A pre- and postcurriculum implementation chart review assessed resident documentation of the 5 components of geriatric ED care: 1) differential diagnosis/patient evaluation considering atypical presentations, 2) determination of baseline function, 3) chronic care facility/caregiver communication, 4) cognitive assessment, and 5) assessment of polypharmacy. A single reviewer assessed 5 pre- and 5 postimplementation charts for each of 18 residents included in the study. We calculated 95% confidence and determined that statistical significance was determined by a 2-tailed z test for 2 proportions, with statistical significance at 0.003 by Bonferroni correction. Results: For falls, resident documentation improved significantly for 1 of 5 measures. For abdominal pain, 2 of 5 components improved. For weakness, 3 of 5 components improved. Conclusion: A geriatric chief complaint–based curriculum improved emergency medicine resident documentation for the care of elderly patients in the ED compared with a non–age-specific chief complaint–based curriculum. [West J Emerg Med. 2011;12(4):484–488.].
机译:简介:我们假设基于老年病首长投诉的教学课程将改善急诊科(ED)中老年患者护理的住院记录。方法:制定并介绍了针对三种最常见的主诉-腹部疼痛,无力和跌倒的老年病主诉课程。课前和课后实施图表审查评估了居民对老年ED护理的5个组成部分的文档:1)考虑到非典型表现的鉴别诊断/患者评估; 2)确定基线功能; 3)慢性护理机构/护理人员沟通; 4)认知评估,以及5)多元药房评估。一位审阅者为研究中包括的18位居民中的每位评估了5个实施前和实施后5个图表。我们计算了95%的置信度,并确定了2个比例的2尾z检验确定的统计学显着性,通过Bonferroni校正的统计学显着性为0.003。结果:对于跌倒,居民文件在5项措施中有1项显着改善。对于腹部疼痛,5种成分中的2种得到了改善。对于弱点,改进了5个组件中的3个。结论:与基于非年龄特定的基于主诉的课程相比,基于老年科的基于主诉的课程改善了急诊住院医师对急诊老年患者的护理记录。 [西急救医学杂志。 2011; 12(4):484-488。]。

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