Connor Carole A, Wright Chris C, Fegan Christopher D
School of Health and Social Sciences, Coventry University, Coventry, UK.
J Adv Nurs. 2002 May;38(4):407-15. doi: 10.1046/j.1365-2648.2002.02198.x.
The aim of this study was to compare the safety and effectiveness of anticoagulant nurses and a consultant haematologist in managing anticoagulant patients in a hospital outpatient setting.
Nurses are increasingly developing roles traditionally undertaken by medical staff. As a result nurse-led practice has expanded in many areas including anticoagulant services. Previous studies have attempted to demonstrate the effectiveness of using other professionals to manage anticoagulant clinics over short periods of time. This research evaluates the safety and effectiveness of a consultant-led and a nurse-led service over two sequential 18-month periods.
A nonexperimental design was adopted. Data were collected retrospectively, from a random sample of 197 patients, who had been managed by both the consultant-led and nurse-led service. Two main outcome measures were selected: anticoagulant control between professional groups and interval between outpatient clinic appointments.
No statistically significant difference in anticoagulant control was found between professional groups (P=0.137). There was evidence that patients attended anticoagulant clinics on significantly fewer occasions with nurse-led management (P < 0.0005).
At the department within which this research was conducted, anticoagulant nurses were found to be at least as safe and effective as the consultant haematologist in managing outpatient anticoagulant patients over the study period. These findings are of importance in both shaping the future provision of anticoagulant care and also contributing to the wider area in evaluating the impact of nurse-led practice within health care.
本研究旨在比较抗凝护士和血液科顾问医生在医院门诊环境中管理抗凝患者的安全性和有效性。
护士越来越多地承担起传统上由医务人员执行的职责。因此，护士主导的实践在包括抗凝服务在内的许多领域都有所扩展。以往的研究试图证明在短时间内使用其他专业人员管理抗凝门诊的有效性。本研究评估了在两个连续的18个月期间，由顾问医生主导和由护士主导的服务的安全性和有效性。
采用非实验性设计。数据通过回顾性收集，来自197名患者的随机样本，这些患者接受过顾问医生主导和护士主导的服务。选择了两个主要的结果指标：不同专业组之间的抗凝控制情况以及门诊预约间隔时间。
不同专业组之间在抗凝控制方面未发现统计学上的显著差异（P = 0.137）。有证据表明，在护士主导的管理模式下，患者前往抗凝门诊就诊的次数明显减少（P < 0.0005）。
在本研究开展的科室中，发现在研究期间，抗凝护士在管理门诊抗凝患者方面至少与血液科顾问医生一样安全有效。这些发现对于塑造未来抗凝护理的提供方式以及在更广泛的领域评估护士主导的实践在医疗保健中的影响都具有重要意义。
