Nemes J, Barnaby K, Shamberger R C
Department of Surgery, Children's Hospital, Boston, MA 02115.
J Pediatr Surg. 1992 Aug;27(8):1038-40; discussion 1041-2. doi: 10.1016/0022-3468(92)90554-k.
Manpower limitations are occurring in residency programs because of fewer residency positions and increasing governmental regulations. This limitation prompted the development of a program to utilize pediatric nurse practitioners (PNPs) in our Department of Surgery. Two began in September 1989. Their role was similar to that of the junior resident and included collaborative management of patients, admission evaluations, discharges, and a variety of procedures. The impact of this program was evaluated by questionnaire to attending surgeons, house staff, and parents. There were 123 surveys mailed (12 attending surgeons, 46 residents, 65 parents). The overall response rate was 51% (100% attending surgeons, 57% residents, and 38% parents). Only two of the attending surgeons had previous experience working with a PNP. All attending surgeons were enthusiastic about the PNP role in managing their patients and felt the PNP had decreased the workload of the resident. Eighty-three percent did not feel the PNP interfered with resident learning; 17% were undecided. Eleven of 12 felt the PNP had helped communication between them and their patients; one was undecided. The resident responses were assessed by level of training. Among senior residents, 82% felt the PNP had decreased the workload of the junior resident and 91% viewed the PNP as a valuable resource, whereas 87% of the junior residents felt the PNP decreased their workload and 100% felt the PNP was a valuable resource. None of the residents felt the PNP interfered with their learning and 73% of the junior residents and 55% of the senior residents felt the PNP contributed to their learning.(ABSTRACT TRUNCATED AT 250 WORDS)
由于住院医师职位减少和政府监管日益严格，住院医师培训项目出现了人力限制。这种限制促使我们外科部门开展了一项利用儿科护士从业者（PNP）的项目。该项目于1989年9月启动了两名PNP。他们的角色与初级住院医师类似，包括患者的协作管理、入院评估、出院以及各种操作。通过向主治外科医生、住院医护人员和家长发放问卷来评估该项目的影响。共邮寄了123份调查问卷（12名主治外科医生、46名住院医师、65名家长）。总体回复率为51%（主治外科医生回复率100%，住院医师57%，家长38%）。只有两名主治外科医生之前有与PNP合作的经验。所有主治外科医生都对PNP在管理患者方面的作用充满热情，并认为PNP减轻了住院医师的工作量。83%的人认为PNP没有干扰住院医师的学习；17%的人不确定。12名医生中有11名认为PNP有助于他们与患者之间的沟通；1名不确定。住院医师的回复根据培训水平进行评估。在高级住院医师中，82%的人认为PNP减轻了初级住院医师的工作量，91%的人认为PNP是宝贵的资源，而87%的初级住院医师认为PNP减轻了他们的工作量，100%的人认为PNP是宝贵的资源。没有住院医师觉得PNP干扰了他们的学习，73%的初级住院医师和55%的高级住院医师认为PNP有助于他们的学习。（摘要截选至250词）
