通过ED咨询的趋势评估住院PA和NP计划的成功
Laura Stock1, Justin Turcotte, Andrea Johnson
1At Luminis Health Anne Arundel Medical Center in Annapolis, Md., Laura Stock is an orthopedic research fellow, Justin Turcotte is director of orthopedic and surgical research, and Andrea Johnson is an orthopedic research fellow and research analyst. Samuel E. Holbert is an orthopedic research fellow at Luminis Health Anne Arundel Medical Center and a general surgery resident at the Medical University of South Carolina in Charleston, S.C. Also at Luminis Health Anne Arundel Medical Center, Matthew Siska practices in orthopedics, Karen Pipkin is an orthopedic NP and lead advanced practice provider for Luminis Health orthopedics, and Chad Patton is an attending orthopedic surgeon and medical director for spine surgery. The authors have disclosed no potential conflicts of interest, financial or otherwise.
实施住院医师助理/助理 (PA) 和执业护士 (NP) 计划减少了骨科咨询和住院时间 (LOS). 外科医生报告说,工作量和护理质量有所改善.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健管理的管理
- 提供先进实践的提供者.
背景情况:
- 住院骨科服务面临的挑战是咨询量和停留时间 (LOS).
- 医生助理/助理 (PA) 和执业护士 (NP) 等高级实践提供者 (APP) 的整合是医疗保健中的一个不断增长的趋势.
研究的目的:
- 评估住院PA和NP计划对骨科咨询量,LOS和急诊室 (ED) 返回的影响.
- 评估外科医生对工作量和计划实施后护理质量的满意度.
主要方法:
- 对4118个骨科ED咨询的回顾性观察性研究 (2017年1月 - 2022年3月).
- 使用单变量统计和多变量回归分析来比较结果并评估影响LOS的因素.
- 调查评估了外科医生对值班工作量,时间安排中断和护理质量的满意度.
主要成果:
- 在计划实施后,骨科外科医生咨询减少,而骨科咨询增加. 观察到LOS的统计学上显著减少.
- 根据病例组合调整后,患者在24小时内出院的可能性增加了47%.
- 超过80%的外科医生报告说,应急工作量和时间安排中断减少,随着护理质量的提高.
结论:
- 一个住院PA和NP计划有效地减少了整形外科医生咨询和医院LOS.
- 该计划提高了外科医生对工作量,时间表效率和整体护理质量的满意度.
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