在全科医院工作的护理人员的临床和成本效益:混合方法的现实评估
Matthew Booker1, Sarah Voss2, Nicky Harris2
1Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Bristol, UK.
Health and social care delivery research
|March 1, 2025
概括
护理人员在一般实践中改善了接入,但需要资源进行培训和监督. 整合影响员工满意度,但证据表明显著的成本或临床结果变化是有限的.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健劳动力整合 医疗保健劳动力整合
- 提供卫生服务 提供卫生服务 提供卫生服务
背景情况:
- 通用诊所面临着需求增加和通用诊所医生的短缺.
- 包括护理人员在内的医疗保健专业人员越来越多地被用于一般实践环境.
- 这项研究解决了了解护理人员在初级保健中的作用和影响的需要.
研究的目的:
- 确定医护人员的模型,将其整合到一般实践中.
- 了解使护理人员在初级保健中发挥有效作用的机制.
- 评估护理人员对安全,成本和患者结果/经验的影响.
主要方法:
- 一个混合方法的现实主义评估,包括一个快速的现实主义审查.
- 在英格兰各地的34个全科医院的案例研究评估.
- 通过定性访谈 (n=69),定量问卷 (n=489) 和电子健康记录 (n=22,509次咨询) 收集数据.
主要成果:
- 在全科医院内,护理人员的角色存在显著的差异.
- 护理人员的整合模式因团队的整合水平和患者的复杂性而异.
- 在一些护理人员站点中,患者报告的安全激活得分较低;对重新咨询,转诊或医院费用产生重大影响的证据有限.
结论:
- 护理人员在一般实践中提高了准入,但需要投资培训和监督的安全性和可接受性.
- 整合影响员工满意度和角色长寿,允许护理人员的专业发展.
- 需要进一步的研究,包括更大的研究和更长的随访,以充分确定临床和成本影响.
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