探索在急诊室实施护士高级能力:一个范围审查
R Franchini1, P Malerba2,3, L Ragazzoni4,5
1Medicina e Chirurgia d Accettazione Ed Urgenza (MeCAU)-Pronto Soccorso, S. Andrea Hospital, 13100, Vercelli, Italy.
Internal and emergency medicine
|November 9, 2025
概括
在急诊室 (ED) 的高级护理角色在改善患者流动和减少等待时间方面表现有前途. 这次审查发现,尽管存在实施挑战,但这些角色是安全有效的,与医生主导的护理可比.
科学领域:
- 紧急医疗 紧急医疗
- 护理实践 护理实践
- 医疗保健系统 医疗保健系统
背景情况:
- 紧急部门 (ED) 过度拥挤是全球医疗保健的一个重大挑战.
- 导致过度拥挤的因素包括缺乏初级保健整合,人员问题和人口老龄化.
- 预计与气候有关的危机将加剧ED压力.
研究的目的:
- 对ED的先进护理实践进行范围审查.
- 识别和描述先进的护理角色,他们的结果,以及相关的促进者和障碍.
- 绘制高收入国家先进护理角色的现有证据.
主要方法:
- 在PubMed,Embase和Scopus数据库中进行了全面的搜索.
- 包括涉及护士在ED中自主执行超出标准护理范围的功能的研究.
- 采用了乔安娜·布里格斯研究所的方法和PRISMA-ScR指南.
主要成果:
- 105项研究符合纳入标准,主要来自加拿大,澳大利亚和美国.
- 确定了三个主要的高级护理角色类别:自主管理 ("看和治疗"),护士领导的患者流量管理和分拣护士订单.
- 这些先进的护理模型展示了可比的护理质量,有效性和满意度,同时减少了等待时间和成本.
结论:
- 先进的护理角色在ED环境中是安全有效的,提供与医生主导的护理相似的结果.
- 有证据表明,这些角色可以减轻ED过度拥挤,提高效率.
- 需要进一步的研究,包括多中心试验,以优化高级护理能力的集成到ED系统中.
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