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What is the scope of practice of the Nurse Practitioner as a surgical assistant in Australia? 执业护士作为澳大利亚外科助理的执业范围是什么?
Q3 Nursing Pub Date : 2020-09-04 DOI: 10.26550/2209-1092.1090
Toni Hains, Catherine Smith
Discussion around the scope of practice of all nurse practitioners (NPs) in Australia was a component of the recent review of NPs’ eligibility to have broader access to the Medical Benefits Schedule (MBS). This review process has been prolonged and, while the MBS review officially concluded on the 30 June 2020, no information regarding decisions about expanded NP access to the MBS for patient rebates had been disclosed at the time of publication. It is anticipated that the MBS review will contribute little change to NP access to the MBS. The MBS is the primary funding process for private-sector medical services in Australia and is a barrier to the scope of practice of Australian NPs. Specifically, in the perioperative setting the lack of access to the ‘assistance at operations’ MBS item numbers limits the NP’s scope of practice as it leaves the private sector surgical patient out-of-pocket when an NP provides surgical assisting services. This discussion paper considers the international non-medical surgical assistant experience and relates this to the Australian context exploring the complexities associated with the term advanced practice nursing, regulation of the NP compared to other clinicians, and the matters of funding and protectionism in the perioperative space.
围绕澳大利亚所有执业护士执业范围的讨论是最近审查执业护士是否有资格更广泛地获得医疗福利计划的一个组成部分。这一审查过程已经延长,虽然MBS审查于2020年6月30日正式结束,但在发布时,没有披露任何关于扩大NP获得MBS以获得患者回扣的决定的信息。预计MBS审查将对NP对MBS的接入贡献很小。MBS是澳大利亚私营医疗服务的主要资助程序,也是澳大利亚NPs执业范围的障碍。具体而言,在围手术期环境中,由于无法获得“手术辅助”MBS项目编号,限制了NP的执业范围,因为当NP提供手术辅助服务时,私营部门的手术患者会自掏腰包。本讨论文件考虑了国际非医疗外科助理的经验,并将其与澳大利亚的背景联系起来,探讨了高级实践护理一词的复杂性、与其他临床医生相比NP的监管,以及围手术期的资金和保护主义问题。
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引用次数: 2
Type 1 diabetes perioperative care: Preventing harm to patients 1型糖尿病围手术期护理:预防对患者的伤害
Q3 Nursing Pub Date : 2020-09-04 DOI: 10.26550/2209-1092.1097
Rebecca Munt
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引用次数: 0
The impact of distractions and interruptions in the operating room on patient safety and the operating room team: An integrative review 手术室中干扰和中断对患者安全和手术室团队的影响:一项综合综述
Q3 Nursing Pub Date : 2020-09-04 DOI: 10.26550/2209-1092.1098
S. Mackenzie, P. Foran
Problem identification: In the operating room (OR), distractions and interruptions are frequent, impacting patient safety, coordination and efficiency and causing errors and patient harm. The OR team is impacted while attempting to perform critical work. This review explores the impact of distractions and interruptions in the OR on patient safety and the OR team. Literature search: Inclusion and exclusion criteria were determined. Six databases were searched with the search criteria for inclusion being in English, peer-reviewed and published between 2014 and 2019. In total 296 papers were identified. Data evaluation synthesis: Duplicates were removed, and 195 papers were screened using inclusion and exclusion criteria. Fourteen studies were included in the review: 12 were quantitative reviews and two were mixedmethod reviews. Methodological quality was assessed using the mixed methods appraisal tool (MMAT), with scores between 60 and 90 per cent. A thematic analysis revealed observational study themes of types, frequency and severity of distractions and interruptions, and impacts upon mental workload, patient safety and the OR team. Simulation study themes included types of distractions and interruptions, and impact on mental workload, clinical decision-making, surgical performance and nurses. Implications for practice or research: The heterogeneity of the literature and paucity of recent nursing and anaesthetic studies highlights that further research is necessary. Nurses can educate and develop policies and interventions to reduce distractions, enhancing patient safety and decreasing the negative impact upon their colleagues and teams.
问题识别:在手术室(OR),干扰和中断是频繁的,影响患者的安全,协调和效率,并造成错误和患者伤害。手术室团队在试图执行关键工作时受到影响。本综述探讨了手术室中干扰和中断对患者安全和手术室团队的影响。文献检索:确定纳入和排除标准。检索了六个数据库,检索标准为2014年至2019年期间发表的英文、同行评审的论文。共鉴定论文296篇。资料评价综合:删除重复,采用纳入和排除标准筛选195篇论文。本综述纳入14项研究:12项为定量综述,2项为混合方法综述。使用混合方法评估工具(MMAT)评估方法学质量,得分在60%到90%之间。专题分析揭示了观察性研究主题的类型、频率和干扰和中断的严重程度,以及对精神负荷、患者安全和手术室团队的影响。模拟研究的主题包括分心和中断的类型,以及对精神负荷、临床决策、手术表现和护士的影响。对实践或研究的启示:文献的异质性和近期护理和麻醉研究的缺乏突出了进一步研究的必要性。护士可以教育和制定政策和干预措施,以减少分心,提高患者安全,减少对同事和团队的负面影响。
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引用次数: 4
Will robots make good perioperative nurses? 机器人会成为优秀的围手术期护士吗?
Q3 Nursing Pub Date : 2020-09-04 DOI: 10.26550/2209-1092.1096
J. Duff
New technology is always being introduced into health care and nursing as a profession has had to adapt. Technological advances have changed the practice of nursing from the introduction of the stethoscope to the electronic health record, and now robots and artificial intelligence (AI). With technological advancements occurring at an ever-increasing rate, more and more perioperative tasks will be delegated to robots and AI. The main question for perioperative nurses is, how can we remain relevant in the high-tech operating room of the future?.
新技术总是被引入医疗保健和护理行业,作为一个职业必须适应。技术进步改变了护理实践,从听诊器的引入到电子健康记录,再到现在的机器人和人工智能。随着技术进步的速度不断加快,越来越多的围手术期任务将委托给机器人和人工智能。围手术期护士的主要问题是,我们如何在未来的高科技手术室中保持相关性?。
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引用次数: 1
A daily measure of job satisfaction in the operating room: investigating its value and viability 手术室工作满意度的日常测量:调查其价值和可行性
Q3 Nursing Pub Date : 2020-07-28 DOI: 10.26550/2209-1092.1082
Miriam James-Scotter, Lixin Jiang, CA Walker, S. Jacobs
Objectives: This study aims to explore the value, validity and viability of implementing a daily job satisfaction tool in the operating room (OR) setting. Sample and setting: A daily one-minute survey was developed and trialled with 269 OR staff members (123 nurses) over a three-week period in one New Zealand hospital. Method: A feedback and validation survey was then administered to staff one week following the trial. Results: The trial resulted in 569 tool submissions. A daily average of 71 per cent of participants (69% nurses) reported feeling ‘pretty good’ or ‘great’ about their jobs, with ‘relationships and communication with colleagues’ most influential for both a positive and negative day at work. Findings also supported the validity of the tool and highlighted strengths and areas for improvement. Conclusion: The results of the study provide initial support for the value and feasibility of implementing a daily job satisfaction measurement tool in the OR setting. A daily satisfaction measure has the potential to be a powerful tool for perioperative nursing managers at all levels enabling active measurement and management of nurse job satisfaction from an interprofessional perspective.
目的:本研究旨在探讨日常工作满意度工具在手术室环境中实施的价值、效度和可行性。样本和环境:对新西兰一家医院的269名手术室工作人员(123名护士)进行了为期三周的每日一分钟调查和试验。方法:在试验后一周对员工进行反馈和验证性调查。结果:试验产生了569个工具提交。平均每天有71%的参与者(69%是护士)表示对自己的工作感觉“非常好”或“非常好”,“与同事的关系和沟通”对工作的积极和消极影响最大。调查结果还支持了该工具的有效性,并突出了优势和有待改进的领域。结论:本研究的结果为在手术室设置中实施日常工作满意度测量工具的价值和可行性提供了初步支持。日常满意度测量有可能成为各级围手术期护理管理者的有力工具,从跨专业的角度积极测量和管理护士的工作满意度。
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引用次数: 1
Pandemics: A COVID-19 perspective 流行病:新冠肺炎视角
Q3 Nursing Pub Date : 2020-06-01 DOI: 10.26550/2209-1092.1092
L. Bowen
[ ]though, how do we define the terms pandemic, epidemic, outbreak and cluster? [ ]the microorganism has to be pathogenic, that is, be able to infect and cause disease in humans [ ]it needs to be able to easily spread between humans6, like COVID-19, which is spread by large droplets, fomite and aerosol transmission from airways and through contaminate surfaces as contact transmission8
[]然而,我们如何定义术语大流行、流行病、暴发和集群?[]微生物必须具有致病性,即能够感染并导致人类疾病[]它需要能够容易地在人与人之间传播6,如新冠肺炎,它通过大飞沫、烟雾和气溶胶从气道传播,并通过污染表面作为接触传播8
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引用次数: 0
Perioperative nurses’ engagement with the surgical safety checklist: A focused ethnography 围手术期护士对手术安全检查表的参与:一个重点人种志
Q3 Nursing Pub Date : 2020-06-01 DOI: 10.26550/2209-1092.1066
Julie A Rogers Mrs, Paul Mr, Jan Alderman Mrs
Purpose: To gain greater insight into how nurses engage with the multidisciplinary team during the surgical safety checklist process. Participants and setting: Participants were a purposeful sample of eight operating room nurses. The study was conducted in the operating room department of a major tertiary teaching hospital in South Australia. Methods: Phase 1 employed participant observations while phase 2 employed semi-structured interviews. Findings: Participants supported the use of the surgical safety checklist and valued its role to enhance patient safety. Multidisciplinary team culture played a significant role in how the checklist was conducted and heavily influenced the level of nurse participation in the process. Observations indicated poor compliance with the nursing review section of the checklist. Conclusions: Multidisciplinary team engagement is important for effective communication during the process of utilising the surgical safety checklist to promote safe outcomes for patients. Nurses are more likely to actively participate in the checklist process if they feel their role is valued by other team members. The nurse-specific area of the checklist is an area for improvement as this tends to be overlooked and considered less important than other checklist items. Modifications in timing the checklist and nurse training may be beneficial to address non-compliance with the nurse area of the checklist.
目的:深入了解护士在手术安全检查表过程中如何与多学科团队合作。参与者和环境:参与者是八名手术室护士的有目的的样本。这项研究是在南澳大利亚一家主要的三级教学医院的手术室进行的。方法:第一阶段采用参与者观察,第二阶段采用半结构化访谈。研究结果:参与者支持使用手术安全检查表,并重视其在提高患者安全方面的作用。多学科团队文化在检查表的执行过程中发挥了重要作用,并严重影响了护士在该过程中的参与程度。观察结果表明,对检查表中护理审查部分的依从性较差。结论:在使用手术安全检查表的过程中,多学科团队的参与对于有效沟通非常重要,以促进患者的安全结果。如果护士觉得自己的角色受到其他团队成员的重视,他们更有可能积极参与检查表过程。检查表中护士特定的领域是一个需要改进的领域,因为这往往被忽视,并且被认为不如其他检查表项目重要。修改检查表的时间安排和护士培训可能有助于解决不符合检查表护士领域的问题。
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引用次数: 3
Who’s under the mask? Colour-differentiated identification labels for perioperative staff 谁在面具下?围手术期工作人员的彩色识别标签
Q3 Nursing Pub Date : 2020-06-01 DOI: 10.26550/2209-1092.1088
D. Bentley
Staff identification in the perioperative environment is difficult when all staff, students and visitors wear the same attire. All attire needs to be laundered to national standards for infection control governance and consequently attire cannot be individualised. In emergency situations it is also difficult to identify the roles of all staff with standard methods of identification. The aim of the ‘Colour-differentiated identification labels’ project was to improve identification of all staff and visitors in the perioperative environment with the intended result being improved communication and safety among staff, patients and visitors. The project began in February 2018 with project leads Diana Bentley and Wendy Howard in the anaesthetics department of the perioperative service in a New South Wales (NSW) public hospital. Disposable identification (ID) labels were initially trialled with the anaesthetic staff for three months. ID labels were designed and printed to give a more uniform appearance. The trial period proved highly successful so the project expanded to include the whole perioperative service at the hospital. Disposable ID labels were subsequently developed that included staff members’ roles, and teams were differentiated by specific colours.
当所有工作人员、学生和访客都穿着相同的服装时,在围手术期环境中很难识别工作人员。所有服装都需要按照感染控制治理的国家标准进行清洗,因此服装不能个性化。在紧急情况下,也很难用标准的识别方法来识别所有工作人员的作用。“彩色识别标签”项目的目的是改善围手术期环境中所有工作人员和访客的识别,其预期结果是改善工作人员、患者和访客之间的沟通和安全。该项目始于2018年2月,项目负责人Diana Bentley和Wendy Howard在新南威尔士州一家公立医院的围手术期麻醉科工作。一次性识别标签最初在麻醉人员中试用了三个月。身份证标签的设计和印刷使其外观更加统一。试验期间证明非常成功,因此该项目扩大到包括医院的整个围手术期服务。随后开发了包括工作人员角色的一次性身份证标签,并按特定颜色区分团队。
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引用次数: 1
The imperative to build research capacity and promote evidence-based practice in Australian perioperative nurses 迫切需要建立研究能力,促进循证实践在澳大利亚围手术期护士
Q3 Nursing Pub Date : 2020-06-01 DOI: 10.26550/2209-1092.1086
J. Duff
Evidence-based practice is considered the gold standard of care, and as such it is now an expectation of our patients, regulatory agencies and health care funders. Unfortunately, much of what we do in perioperative nursing continues to be based on tradition and history rather than robust clinical evidence. Even when evidence is available to use, it is often not fully applied in practice. If we want to maintain our standing as a leading nursing specialty, then we need to address this issue by engaging with research and growing our evidence base. To do this, we need to conduct and disseminate rigorous primary research, clinically relevant systematic reviews and evidence-based practice projects.
循证实践被认为是护理的黄金标准,正因为如此,它现在是我们的病人、监管机构和卫生保健资助者的期望。不幸的是,我们在围手术期护理中所做的大部分工作仍然基于传统和历史,而不是强有力的临床证据。即使有可用的证据,在实践中也常常得不到充分的应用。如果我们想保持我们作为领先护理专业的地位,那么我们需要通过参与研究和增加我们的证据基础来解决这个问题。为此,我们需要开展和传播严格的初步研究、临床相关的系统评价和循证实践项目。
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引用次数: 4
The effectiveness of a telehealth program on the anxiety levels among women with core needle biopsy for suspected breast cancer 远程医疗计划对疑似乳腺癌症核心针活组织检查女性焦虑水平的有效性
Q3 Nursing Pub Date : 2020-06-01 DOI: 10.26550/2209-1092.1071
Sansanee Ruttanamontree, Usavadee Asdornwised, Kessiri Wongkongkam, S. Chuthapisith
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引用次数: 1
期刊
Journal of Perioperative Nursing
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