护士与医生的决策在ED中,用于在儿科喘中短期服用β2-激动剂
Nitai A Levy1, Shereen Hawash2, Riad Shiekh2
1Department of Pediatric Emergency, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
The American journal of emergency medicine
|January 21, 2025
概括
三级护士准确地评估了需要短效β2抗体支气管扩展剂的儿童,与医生有强烈的共识. 护士有效地发现了需要进一步治疗的严重病例.
科学领域:
- 儿科急救医学 儿科急救医学
- 临床护理实践 临床护理实践
- 呼吸系统护理 呼吸系统护理
背景情况:
- 诊断护士在患者的初始评估中起着至关重要的作用.
- 确定儿童呼吸短促时需要支气管扩展剂治疗的必要性至关重要.
研究的目的:
- 为了评估临床判断的选护士在决定是否需要短效β2-激动剂支气管扩展剂治疗的儿科患者呼吸短促.
- 为了比较护士主导的决策与医生评估,而没有事先的医生评估.
主要方法:
- 前性研究比较分组护士和医生对支气管扩展剂治疗必要性的决定.
- 护士评估儿童 (2-18岁) 呼吸短促,包括病史,生命体征和听觉.
- 护士根据预先定义的标准做出治疗决定;医生独立评估患者.
主要成果:
- 在护士 (87.1%) 和医生 (83.9%) 之间对支气管扩展剂的使用决策没有统计学上显著的差异.
- 临床症状的检测也相似,护士在诊断出刻时的频率较低 (48.4%与71%相比).
- 在决策中,护士与医生的相关性很强 (准确率为83.9%,kappa为0.351).
结论:
- 三级护士表现出与医生相似的临床判断力,以确定儿童呼吸短促的支气管扩展剂需求.
- 护士在识别需要额外治疗的患者方面表现出熟练,特别是在严重病例中.
- 这些发现支持护士在特定儿科紧急情况下独立启动支气管扩展剂治疗的潜力.
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