Australasian Emergency Care最新文献_第3页

What are the training needs of emergency department resuscitation nurses? A scoping review 急诊科复苏护士的培训需求是什么？范围界定审查。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-07-03 DOI: 10.1016/j.auec.2024.06.001

Josephine Rheinberger , Kate Curtis , Andrea McCloughen , Taneal Wiseman

Background

The emergency resuscitation nurse is a challenging and specialised role at the forefront of critical care practice in the emergency department. Despite their extensive specialist knowledge and skill requirements, in Australia there is no state-wide or nationally agreed approach to how to best provide training that meets a set of fixed objectives and requisite skills for resuscitation nurses. Due to an ageing nursing population and increasing workforce attrition, an efficacious accelerated pathway to acquire specialist resuscitation nursing knowledge, is necessary.

Aim

The aim of this review is to identify, consolidate and summarise the available evidence on the training needs for the requisite clinical and non-technical skills of emergency resuscitation nurses

Eligibility criteria

Papers about nurses currently working in the emergency department; including Nurse Unit Managers (NUMs), Clinical Nurse Educators (CNEs), Clinical Nurse Consultants (CNCs), Clinical Nurse Specialists (CNSs), Registered Nurses (RNs) and Enrolled Nurses (ENs) were included. The review included primary and non-primary research, including papers addressing how emergency nurses are trained. There was no date limitation set to ensure all results could be reviewed. Papers that were not published in English, included nurses who were not working in the ED, or included doctors, allied health, and other staff where population cohorts could not be distinguished, were excluded. Abstract only, editorials, conference posters or oral presentations, were also excluded.

Sources of evidence

Searches were conducted in MEDLINE, CINAHL and EMCARE. The authors conducted extensive hand-searching of the included study reference lists as well as the grey literature to ensure that all relevant literature was captured.

Methods

A scoping literature review was conducted.

Results

Data extraction was conducted on the final 33 articles (23 peer reviewed studies and 10 competency and practice standards documents). Specific training requirements to achieve competence in the requisite clinical and non-technical skills in resuscitation nursing do not exist. A decline in competency without regular reinforcement was reported. Multi-modal approaches, incorporating diverse teaching methods, show potential in enhancing knowledge retention and skill acquisition.

Conclusion

Resuscitation nursing lacks a standardised training approach in Australia, leading to a gap in ensuring consistent skill acquisition and knowledge among nurses. Research is required to identify what resuscitation nursing skills and training are necessary to ensure practice effectively meets the needs of patients.

背景：急诊复苏护士是急诊科重症监护实践最前沿的一个具有挑战性的专业角色。尽管急诊复苏护士需要具备广泛的专业知识和技能，但在澳大利亚，对于如何以最佳方式提供培训，以实现复苏护士的一系列固定目标和必备技能，目前还没有全州或全国性的统一方法。由于护理人口老龄化和劳动力自然减员的增加，有必要制定一个有效的加速途径来获取专业复苏护理知识。目的：本综述旨在识别、整合和总结有关急诊复苏护士必要临床和非技术技能培训需求的现有证据：有关目前在急诊科工作的护士的论文，包括护理单元管理者 (NUM)、临床护士教育者 (CNE)、临床护士顾问 (CNC)、临床专科护士 (CNS)、注册护士 (RN) 和注册护士 (EN) 均包括在内。综述包括主要研究和非主要研究，其中包括关于如何培训急诊护士的论文。没有设定日期限制，以确保能对所有结果进行审查。非英文发表的论文、包含非急诊室护士的论文或包含医生、专职医疗人员及其他无法区分人群的工作人员的论文均被排除在外。此外，还排除了仅有摘要、社论、会议海报或口头报告的文章：在 MEDLINE、CINAHL 和 EMCARE 中进行了检索。作者对收录的研究参考文献目录以及灰色文献进行了广泛的手工检索，以确保所有相关文献都被收录：方法：进行范围界定文献综述：对最后 33 篇文章（23 篇同行评审研究和 10 篇能力与实践标准文件）进行了数据提取。在复苏护理中，并不存在达到必要的临床和非技术技能能力的具体培训要求。有报告称，如果没有定期强化，能力会下降。结合多种教学方法的多模式方法在提高知识保持率和技能掌握率方面显示出潜力：结论：在澳大利亚，复苏护理缺乏标准化的培训方法，因此在确保护士获得一致的技能和知识方面存在差距。需要开展研究，确定哪些复苏护理技能和培训是确保实践有效满足患者需求所必需的。

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引用次数: 0

Determinants of work stress among emergency department nurses in Sleman, Yogyakarta, Indonesia 印度尼西亚日惹苏莱曼市急诊科护士工作压力的决定因素。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-07-02 DOI: 10.1016/j.auec.2024.06.002

Happy Indah Kusumawati , Suis Galischawati , Sri Warsini , Bayu Fandhi Achmad , Nurul Aida Fatma , Nazhifah Salsabila Tiyani , Dewi Nirmalasari , Eko Budi Santoso

Background

The nursing field is the fourth most stressful occupation in the health sector. Emergency department nurses often face crises and unpredictable situations that can negatively affect their quality of life and the quality of care. This study aimed to investigate the determinants of work stress among ED nurses in Sleman, Yogyakarta, Indonesia.

Methods

A descriptive cross-sectional study was conducted. Participants (n = 122) were emergency nurses recruited through convenience sampling from four EDs in Sleman District, Yogyakarta, Indonesia. Data were gathered using an online self-administered survey consisting of the workload, self-efficacy, and work stress questionnaires. Hierarchical linear regression analysis with the entry method was used to examine the main determinants of work stress.

Results

The average work stress (38.29 ± 8), workload (30.83 ± 9.21), and self-efficacy (32.47 ± 3.61) scores were at a moderate level. Hierarchical linear regression showed that workplace, being a head nurse, and workload were the main determinants that contributed to 25.4 % of work stress among ED nurses.

Conclusions

The study results confirm that having a high workload, working in a private hospital, and being a head nurse are the main determinants of work stress among ED nurses in Sleman, Indonesia.

背景介绍护理领域是卫生部门第四大压力职业。急诊科护士经常面临危机和不可预测的情况，这可能会对她们的生活质量和护理质量产生负面影响。本研究旨在调查印度尼西亚日惹市 Sleman 的急诊科护士工作压力的决定因素：方法：进行了一项描述性横断面研究。参与者（n = 122）是通过方便抽样从印度尼西亚日惹市斯莱曼区的四家急诊室招募的急诊室护士。数据收集采用在线自填式调查，包括工作量、自我效能感和工作压力问卷。采用分层线性回归分析法研究工作压力的主要决定因素：工作压力（38.29 ± 8）、工作量（30.83 ± 9.21）和自我效能感（32.47 ± 3.61）的平均得分处于中等水平。层次线性回归显示，工作场所、担任护士长和工作量是造成急诊室护士工作压力的主要决定因素，占 25.4%：研究结果证实，工作量大、在私立医院工作和担任护士长是印尼斯莱曼市急诊室护士工作压力的主要决定因素。

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引用次数: 0

The experiences of patients not conveyed after evaluation by emergency medical services in Southwest Finland – A qualitative survey study 芬兰西南部急救医疗服务评估后未转送病人的经历 - 一项定性调查研究。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-05-23 DOI: 10.1016/j.auec.2024.05.001

Anne Kuoppala , Eetu Skaffari , Timo Iirola , Hilla Nordquist

Background

The amount of non-critical Emergency Medical Services missions has been increasing. After examination and treatment, paramedics can decide, based on guidelines, not to convey the patient to a healthcare facility. This study aimed to investigate patients’ experiences in non-conveyance situations in Southwest Finland. Our research questions were: 1) Which patient concerns were not addressed? 2) What key actions improved patient comfort? and 3) What possible enhancements could make the patient experience more positive?

Methods

This was a qualitative survey study. In March 2023, all the patients who met the inclusion criteria (N = 1017) received a survey via mail. The data from three open-ended questions were analyzed using inductive content analysis.

Results

The response rate was 22.2 % (n = 226). The unaddressed patient concerns were related to inadequate immediate care and guidance and non-clinical factors causing concern. Key actions for improved patient comfort were related to immediate treatment and guidance, as well as non-clinical factors that impact the patient experience. More thorough treatment processes and more attentive encounters would have enhanced the patient experience.

Conclusions

Predominantly, patients reported having received excellent services. Utilizing paramedics’ soft skills and keeping the patient as the central focus is key to improving the non-conveyance process and experience.

背景：非危急情况下的紧急医疗服务任务越来越多。在检查和治疗后，辅助医务人员可根据指南决定不将病人转送至医疗机构。本研究旨在调查芬兰西南部病人在非转送情况下的经历。我们的研究问题是1) 哪些病人关心的问题没有得到解决？2）哪些关键措施可以改善患者的舒适度？这是一项定性调查研究。2023 年 3 月，所有符合纳入标准的患者（N = 1017）都收到了一份邮寄调查问卷。采用归纳内容分析法对三个开放式问题的数据进行了分析：答复率为 22.2%（n = 226）。未解决的患者关切问题与即时护理和指导不足以及引起关切的非临床因素有关。改善患者舒适度的关键措施与即时治疗和指导以及影响患者体验的非临床因素有关。更彻底的治疗过程和更周到的服务将改善患者的就医体验：大多数患者都表示得到了优质服务。利用辅助医务人员的软技能并始终以患者为中心是改善非转运过程和体验的关键。

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引用次数: 0

Exploring paramedic personality profiles and the relationship with burnout and employment retention: A scoping review 探索辅助医务人员的性格特征及其与职业倦怠和就业保留的关系：范围审查。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-05-22 DOI: 10.1016/j.auec.2024.04.003

Chloe Betts, Alannah Stoneley, Tara Picker

Background

Paramedics play a pivotal role in delivering emergency medical care, contributing to excellence in the prehospital environment and ensuring a seamless continuum of healthcare. Achieving this objective is subject to various factors. This review aims to explore, the relationship between paramedic personality profiles and key factors including stress, burnout and employment retention or attrition.

Methods

The JBI approach was used to perform a scoping review. Key words including paramedic* , ambulance* , personalit* , retention OR attrition and burnout OR stress were inserted into the search engines OVID, CINAHL Plus, Scopus, Web of Science Core Collection, Psychology ProQuest, and Nursing ProQuest. Titles and abstracts of 226 results were screened and inclusion and exclusion criteria applied. Full texts of the remaining 18 results were screened to inform the results.

Results

Three themes emerged relevant to the objective including the correlation of neuroticism with stress and burnout, personality types and mental illness with the ability to cope during stressful situations and finally resilience and burnout with the intention to quit.

Conclusion

Further research should be completed into specific personality characteristics, including neuroticism, perfectionism, and excitability to facilitate the development of strategies aimed at improving the health and wellbeing of paramedics and EMT workers internationally.

背景：辅助医务人员在提供紧急医疗护理、改善院前环境和确保无缝持续医疗保健方面发挥着关键作用。这一目标的实现受到各种因素的制约。本综述旨在探讨辅助医务人员的个性特征与压力、职业倦怠和留职或减员等关键因素之间的关系：方法：采用 JBI 方法进行范围界定综述。在 OVID、CINAHL Plus、Scopus、Web of Science Core Collection、Psychology ProQuest 和 Nursing ProQuest 等搜索引擎中插入了包括辅助医务人员*、救护车*、个性*、留职或减员和倦怠或压力在内的关键词。筛选了 226 项结果的标题和摘要，并应用了纳入和排除标准。对其余 18 项成果的全文进行了筛选，以便为结果提供信息：出现了三个与目标相关的主题，包括神经质与压力和职业倦怠的相关性、人格类型和精神疾病与压力情况下的应对能力的相关性，以及抗压能力和职业倦怠与辞职意向的相关性：应进一步研究特定的人格特征，包括神经质、完美主义和兴奋性，以促进制定旨在改善国际护理人员和急救人员健康和福祉的战略。

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引用次数: 0

Vital signs monitoring in Australasian emergency departments: Development of a consensus statement from ACEM and CENA 澳大利亚急诊科的生命体征监测：ACEM 和 CENA 编制共识声明。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-05-20 DOI: 10.1016/j.auec.2024.04.001

Background

Emergency Department (ED) care is provided for a diverse range of patients, clinical acuity and conditions. This diversity often calls for different vital signs monitoring requirements. Requirements often change depending on the circumstances that patients experience during episodes of ED care.

Aim

To describe expert consensus on vital signs monitoring during ED care in the Australasian setting to inform the content of a joint Australasian College for Emergency Medicine (ACEM) and College of Emergency Nursing Australasia (CENA) position statement on vital signs monitoring in the ED.

Method

A 4-hour online nominal group technique workshop with follow up surveys.

Results

Twelve expert ED nurses and doctors from adult, paediatric and mixed metropolitan and regional ED and research facilities spanning four Australian states participated in the workshop and follow up surveys. Consensus building generated 14 statements about vital signs monitoring in ED. Good consensus was reached on whether vital signs should be assessed for 15 of 19 circumstances that patients may experience.

Conclusion

This study informed the creation of a joint position statement on vital signs monitoring in the Australasian ED setting, endorsed by CENA and ACEM. Empirical evidence is needed for optimal, safe and achievable policy on this fundamental practice.

背景：急诊科（ED）的病人、临床严重程度和病情多种多样。这种多样性往往需要不同的生命体征监测要求。目的：描述澳大拉西亚地区专家对急诊科护理期间生命体征监测的共识，为澳大拉西亚急诊医学学院（ACEM）和澳大拉西亚急诊护理学院（CENA）关于急诊科生命体征监测的联合立场声明的内容提供信息：结果：12 名急诊科护士和医生专家参加了研讨会：来自澳大利亚四个州的成人、儿科、大都市和地区混合急诊室以及研究机构的 12 名专家级急诊室护士和医生参加了研讨会和后续调查。在建立共识的过程中，产生了 14 项关于急诊室生命体征监测的声明。在患者可能遇到的 19 种情况中，就 15 种情况是否应评估生命体征达成了良好共识：这项研究为制定澳大拉西亚急诊室生命体征监测联合立场声明提供了信息，该声明得到了 CENA 和 ACEM 的认可。关于这一基本实践的最佳、安全和可行政策需要经验证据。

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引用次数: 0

The significance of paramedic communication during women’s birth experiences: A scoping review 在妇女分娩过程中辅助医务人员沟通的重要性：范围综述。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-05-11 DOI: 10.1016/j.auec.2024.04.002

Background

Internationally, over one-third of women experience birth trauma, leading to adverse mental health outcomes. Poor communication with healthcare professionals is a primary contributing factor. Paramedics attend various clinical presentations, including childbirth, yet their potential impact on women's birth experiences has been largely overlooked.

Methods

A systematic literature search was conducted following the Joanna Briggs Institute methodological framework. The search identified 1015 potentially suitable articles, and 5 articles met the inclusion criteria. Data was analysed using reflexive thematic analysis from a feminist standpoint.

Results

Three themes were generated: 1. First Impressions Count: paramedic demeanour impacted the woman's sense of safety and perception of paramedic clinical competence. 2. Choice as a Pathway to Control: when paramedics involved women in decision-making, it led to empowerment, while non-involvement led to women becoming passive participants. 3. Exposed, Violated and Disempowered: some paramedics disrespected and abused women, treating them solely as objects for the purpose of producing a baby.

Conclusions

This review highlights the influence of paramedic communication on women's birth experiences. While some paramedics communicated respectfully, other paramedics were the perpetrators of Obstetric Violence. Future research should inform paramedic education and improve outcomes for birthing women.

背景：在国际上，超过三分之一的妇女经历过分娩创伤，导致不良的心理健康后果。与医护人员沟通不畅是主要原因。辅助医务人员参与了包括分娩在内的各种临床表现，但他们对妇女分娩经历的潜在影响却在很大程度上被忽视了：按照乔安娜-布里格斯研究所的方法框架进行了系统的文献检索。搜索共发现 1015 篇潜在的合适文章，其中 5 篇符合纳入标准。从女性主义立场出发，采用反思性主题分析法对数据进行了分析：产生了三个主题：1.第一印象很重要：辅助医务人员的举止影响了女性的安全感和对辅助医务人员临床能力的感知。2.2. 选择是控制的途径：当辅助医务人员让妇女参与决策时，会赋予妇女权力，而不参与则会使妇女成为被动的参与者。3.暴露、侵犯和剥夺权力：一些辅助医务人员不尊重和虐待妇女，只把她们当作生孩子的物品：本综述强调了辅助医务人员的沟通对产妇分娩经历的影响。虽然有些辅助医务人员的沟通方式令人尊敬，但有些辅助医务人员却是产科暴力的实施者。未来的研究应为辅助医务人员的教育提供依据，并改善分娩妇女的结果。

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引用次数: 0

Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: A consensus process 设计用于澳大利亚新南威尔士州农村、地区和大都市的标准化急诊护士职业途径：达成共识的过程。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-03-26 DOI: 10.1016/j.auec.2024.03.002

Background

Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments.

Methods

An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023.

Results

An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner’s novice to expert theory.

Conclusion

A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions.

背景：急诊护士是在急诊室接诊病人的第一批临床医生；她们的工作对病人的安全至关重要。为了减少临床差异，提高急诊护理的安全性和质量，我们制定了基于共识的标准化急诊护士职业发展路径，供澳大利亚农村、地区和新南威尔士州（NSW）大都市急诊部门使用：方法：我们对来自六家医疗服务机构、澳大利亚急诊护理学院和新南威尔士州卫生部的职业发展途径进行了分析。一个由 15 名成员组成的专家小组在 2023 年 5 月至 8 月期间举行的六次面对面会议上，采用协商一致的程序制定了职业发展路径，并确定了职业发展路径的教育需求：结果：八步路径概述了护士通过与不同急诊室临床领域相关的护理模式取得进展的过程，从新手到专家至少需要 172 小时的面授保护教育和 8 小时的在线教育。根据本纳从新手到专家的理论，护士的晋升与复杂程度、决策制定和临床技能的提高相一致：结论：至少 180 小时的标准化职业途径将使急诊护理培训采用一致的方法，并使护士能够在其全部执业范围内工作。这将促进急诊护理技能在不同辖区之间的转移。

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引用次数: 0

Exploring clinicians' insertion experience with a new peripheral intravenous catheter in the emergency department 探索临床医生在急诊科使用新型外周静脉导管的插入经验。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-03-15 DOI: 10.1016/j.auec.2024.03.001

Background

Hospitals frequently introduce new medical devices. However, the process of clinicians adapting to these new vascular access devices has not been well explored. The study aims to explore clinicians’ experience with the insertion of a new guidewire peripheral intravenous catheter (PIVC) introduced in the emergency department (ED) setting.

Methods

The study was conducted at two EDs in Queensland, Australia, utilising a qualitative explorative approach. Interviews were conducted with guidewire PIVC inserters, including ED doctors and nurses, and field notes were recorded by research nurses during insertions. Data analysis was performed using inductive content analysis, from which themes emerged.

Results

The study compiled interviews from 10 participants and field notes from 191 observation episodes. Five key themes emerged, including diverse experience, barriers related to the learning process, factors influencing insertion success, and recommendations to enhance clinicians’ acceptance. These themes suggest that the key to successful adoption by clinicians lies in designing user-friendly devices that align with familiar insertion techniques, facilitating a smooth transfer of learning.

Conclusion

Clinician adaptation to new devices is vital for optimal patient care. Emergency nurses and doctors prefer simplicity, safety, and familiarity when it comes to new devices. Providing comprehensive device training with diverse training resources, hands-on sessions, and continuous expert support, is likely to enhance clinician acceptance and the successful adoption of new devices in ED settings.

背景：医院经常引进新的医疗设备。然而，临床医生对这些新血管通路设备的适应过程还没有很好的研究。本研究旨在探讨临床医生在急诊科（ED）环境中插入新型导丝外周静脉导管（PIVC）的经验：研究在澳大利亚昆士兰州的两家急诊室进行，采用了定性探索方法。研究人员与导丝 PIVC 插入者（包括急诊科医生和护士）进行了访谈，研究护士在插入过程中进行了现场记录。数据分析采用归纳内容分析法，并从中得出主题：研究汇编了 10 位参与者的访谈和 191 次观察的现场记录。研究发现了五个关键主题，包括不同的经验、与学习过程相关的障碍、影响插入成功的因素以及提高临床医生接受度的建议。这些主题表明，临床医生成功采用新设备的关键在于设计用户友好型设备，使其与熟悉的插入技术保持一致，从而促进学习的顺利进行：结论：临床医生对新设备的适应对于优化患者护理至关重要。急诊护士和医生在使用新设备时更倾向于简单、安全和熟悉。通过多样化的培训资源、实践课程和持续的专家支持，提供全面的设备培训很可能会提高临床医生的接受度，并促进急诊室成功采用新设备。

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引用次数: 0

Characteristics and outcomes of emergency department presentations brought in by police with and without an emergency examination authority: A state-wide cohort study 拥有和不拥有急诊检查权的警察带来的急诊室就诊者的特征和结果：一项全州范围的队列研究。

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-03-11 DOI: 10.1016/j.auec.2024.02.001

Background

The aim of this study was to describe and compare the demographic characteristics, clinical characteristics and patient and health service outcomes of emergency department (ED) presentations brought in by police with and without an emergency examination authority.

Methods

A retrospective cohort study of adult (≥ 18 years old) presentations brought in by police to EDs in Queensland, Australia from 01 January 2018 to 31 December 2020. Routinely collected ED data were used to describe and compare the demographic characteristics, clinical characteristics, and outcomes of people brought in by police with and without an emergency examination authority.

Results

A total of 42 502 adult ED presentations were brought in by police over the three-year period, of which 22 981 (44.7%) had an emergency examination authority. Compared with presentations brought in by police without an emergency examination authority, those brought in by police with an emergency examination authority had a higher proportion of presentations for mental health problems, were from major cities, and were allocated more urgent Australasian Triage Scale categories. Presentations brought in by police with an emergency examination authority were less likely to be seen within their Australasian Triage Scale timeframe and experienced a longer length of stay than those brought in by police without an emergency examination authority whether admitted (217 mins vs. 186 mins, p < 0.001) or discharged (212 mins vs. 97 mins, p < 0.001).

Conclusions

The characteristics and outcomes of people brought in by police with emergency examination authorities differed to those brought in by police without emergency examination authorities. Further research is required to enhance understanding of this relatively unexplored group of people and foster interagency collaborations.

背景：本研究的目的是描述和比较有急诊检查权和没有急诊检查权的警察带来的急诊患者的人口特征、临床特征以及患者和医疗服务结果：本研究旨在描述和比较有急诊检查权限和无急诊检查权限的警察带来的急诊科（ED）就诊者的人口统计学特征、临床特征以及患者和医疗服务结果：这是一项回顾性队列研究，研究对象为 2018 年 1 月 1 日至 2020 年 12 月 31 日期间澳大利亚昆士兰州由警方带入急诊科的成人（≥ 18 岁）患者。常规收集的急诊室数据用于描述和比较有急诊检查权限和无急诊检查权限的警察带来的患者的人口统计学特征、临床特征和结果：三年内，警方共接诊 42 502 名成人急诊患者，其中 22 981 人（44.7%）拥有急诊检查权限。与无急诊检查权的警察带来的就诊者相比，有急诊检查权的警察带来的就诊者中因精神健康问题就诊的比例更高，他们来自大城市，并被分配到更紧急的澳大拉西亚分流量表类别中。与没有紧急检查权的警察带来的病人相比，有紧急检查权的警察带来的病人不太可能在澳大拉西亚分诊量表规定的时间内得到诊治，而且住院时间更长（217 分钟对 186 分钟，P）：有紧急检查权的警察和无紧急检查权的警察送来的病人的特征和结果不同。需要开展进一步的研究，以加深对这一相对未开发群体的了解，并促进机构间的合作。

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引用次数: 0

Providing end of life care in the emergency department: A hermeneutic phenomenological study 在急诊科提供临终关怀：诠释学现象学研究

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care

Pub Date : 2024-02-02 DOI: 10.1016/j.auec.2024.01.002

Background

Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the emergency department.

Methods

A hermeneutic phenomenological study was conducted in 2021, using semi-structured interviews with seven registered nurses across two hospital emergency departments in Queensland, Australia. Thematic analysis of participants’ narratives was undertaken.

Findings

Seven registered nurses were interviewed; six of whom were women. Participant’s experience working in the emergency department setting ranged from 2.5–20 years. Two themes were developed through analysis: (i) Presenting the patient as a dying person; and (ii) Mentalising death in the context of the emergency department.

Conclusions

Nurses providing end of life care in the emergency department draw upon their personal and aesthetic knowing to present the dying patient as a person. The way death is mentalised suggests the need to develop empirical knowing about ageing and supportive medical care and ethical knowing to assist with the transition from resuscitation to end of life care. Shared clinical reflection on death in the emergency department, facilitated by experts in ageing and end of life care is recommended.

背景注册护士表示，在急诊科提供临终关怀具有挑战性。研究目的是了解注册护士在急诊科为老年人提供临终关怀服务的感受。方法在 2021 年进行了一项诠释学现象学研究，在澳大利亚昆士兰州的两家医院急诊科对七名注册护士进行了半结构化访谈，并对参与者的叙述进行了主题分析。研究结果七名注册护士接受了访谈，其中六名为女性。参与者在急诊科的工作经验为 2.5-20 年不等。通过分析提出了两个主题：(i) 将病人作为临终者；(ii) 在急诊科环境中将死亡心理化。死亡心理化的方式表明，有必要发展有关老龄化和支持性医疗护理的经验知识和伦理知识，以协助从复苏到生命末期护理的过渡。建议在老龄化和临终关怀专家的协助下，在急诊科共同对死亡进行临床反思。

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引用次数: 0