Coombs Maureen A, Moorse Sue E
Intensive Care Unit, D Level Centre Block, Southampton General Hospital, Tremona Road, Southampton S016 6YD, UK.
Intensive Crit Care Nurs. 2002 Aug;18(4):200-10. doi: 10.1016/s0964339702000447.
This paper proposes that the current use of physical assessment skills within critical care nursing practice is part of a on-going nursing role development process. A review of the critical care nursing role highlights how nurses in this setting have always been responsive to patient management needs. In exploring one recent nursing role development, the critical care outreach nurse, it is suggested that enhanced assessment skills enable these practitioners to safely and competently assess critically ill patients out of the intensive care environment. The use of patient case studies in this paper, demonstrate how the theory of a more intensive physical assessment knowledge base can be applied in the everyday practice of an critical care outreach nurse. Through such systematic patient review, patient management plans can be agreed and ward based practitioners can be supported in the on-going treatment of sick ward patients. The use of the cases presented also highlights the complexity of the outreach nurse's practice in addressing clinical management and team management issues.
本文提出，当前在重症护理实践中运用身体评估技能是护理角色持续发展过程的一部分。对重症护理角色的回顾凸显了该环境下的护士如何始终对患者管理需求做出响应。在探讨近期的一项护理角色发展——重症护理外展护士时，有人认为增强的评估技能使这些从业者能够在重症监护环境之外安全、胜任地评估重症患者。本文中患者案例研究的运用，展示了更深入的身体评估知识库理论如何应用于重症护理外展护士的日常实践。通过这种系统的患者评估，可商定患者管理计划，并在病房患者的持续治疗中为病房从业者提供支持。所呈现案例的运用还凸显了外展护士在处理临床管理和团队管理问题时实践的复杂性。
