Evaluation of nurse practitioners' extended scope of practice in a regional hospital emergency department in tropical Australia.

IF 1.9 4区 医学 Q2 NURSING Australian Journal of Rural Health Pub Date : 2024-10-09 DOI:10.1111/ajr.13190
Angela Jackson, Chris Hawkins, Theona Stone, Petra Anderson, Frances Wilesmith, Mark Little
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Abstract

Objectives: There is very little literature examining the workload and impact of nurse practitioners (NPs) working in emergency departments (ED) in regional and rural Australia. The aim of this paper was to review the ED NPs scope of practice in the ED discharge stream and patient outcomes at Cairns Hospital over a 7-month period.

Methods: This retrospective study examined the ED electronic medical record between 14 May 2019 and 31 December 2019. Cases managed by ED NPs, referrals, procedures performed, representations and disposition data were collected. Adverse events were sought from the Qld Health adverse events register (Riskman), the department complaints register and the ED M&M meeting minutes.

Results: A total of 1443 patients were treated by NPs, with ages ranging from 0 to 98 years (median 40 years). Australasian Triage Score (ATS) 3 cases made up 30% of the workload. Other than ATS 3 cases, time to being seen was better than the general department. There were very few unexpected representations, complaints or adverse events.

Conclusions: This study supports the view that NPs working in a regional emergency department can safely manage a variety of patients outside a fast-track model, with a wide age range and a variety of triage categories and diagnoses. We believe this has important implications for the provision of emergency care, especially in regional and rural Australia.

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对澳大利亚热带地区一家地区医院急诊科执业护士扩大执业范围的评估。
目的:有关澳大利亚地区和农村地区急诊科执业护士(NPs)的工作量和影响的文献极少。本文旨在回顾凯恩斯医院急诊科执业护士在急诊科出院流程中的执业范围以及患者在7个月内的治疗效果:这项回顾性研究检查了 2019 年 5 月 14 日至 2019 年 12 月 31 日期间的急诊室电子病历。研究收集了急诊科 NP 管理的病例、转诊情况、执行的程序、陈述和处置数据。从Qld Health不良事件登记簿(Riskman)、科室投诉登记簿和急诊室M&M会议记录中收集了不良事件:结果:共有 1443 名患者接受了 NP 治疗,年龄从 0 岁到 98 岁不等(中位数为 40 岁)。澳大利亚分诊评分(ATS)3级病例占工作量的30%。除澳大利亚分流评分 3 级病例外,其他病例的就诊时间均优于普通科室。很少出现意外陈述、投诉或不良事件:这项研究支持这样一种观点,即在地区急诊科工作的非专业人员可以在快速通道模式之外安全地处理各种病人,这些病人的年龄跨度很大,分诊类别和诊断也多种多样。我们认为这对急诊护理的提供具有重要意义,尤其是在澳大利亚的地区和农村地区。
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来源期刊
Australian Journal of Rural Health
Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.30
自引率
16.70%
发文量
122
审稿时长
12 months
期刊介绍: The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.
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