Read S M, Jones N M, Williams B T
Department of Public Health Medicine, University of Sheffield Medical School.
BMJ. 1992 Dec 12;305(6867):1466-70. doi: 10.1136/bmj.305.6867.1466.
To determine the distribution and scope of nurse practitioner schemes in accident and emergency departments in England and Wales; to describe the caseloads of doctors and nurse practitioners on two representative days; and to estimate the number of patients managed by nurse practitioners in the year to 31 March 1991.
A postal survey of accident and emergency departments and a content analysis of case notes of new patients attending a representative sample of accident and emergency departments on two days.
All accident and emergency departments in England and Wales.
560 nurses in charge of accident and emergency departments. Census: case notes of 5814 patients in 37 accident and emergency departments.
number of accident and emergency departments with nurse practitioner schemes. Census: demographic and clinical characteristics of new patients attending and whether nurse practitioner or doctor made diagnoses and ordered investigations, treatments, referrals, discharges.
513 replies (92%) from 465 surveyed functioning accident and emergency departments and 48 departments recently closed. 27 (6%) departments used designated nurse practitioners and 159 (34%) "unofficial" nurse practitioners. Only 530 (9%) of the 5814 patients in the census were managed entirely or mainly by nurse practitioners, with higher proportions in ophthalmic departments (nearly 30%) and minor casualty departments (over 40%) than in major departments (3%). Most patients managed by nurse practitioners (86%) had minor trauma. In the year ending 31 March 1991 an estimated 390,000 (95% confidence interval 260,000 to 520,000) patients out of a total of 12.5 million (3.1%, 2.1% to 4.1%) were clinically managed by a nurse practitioner.
Designated nurse practitioner schemes are rare. The volume and range of nurse practitioner work in major general accident and emergency departments is small compared with those in specialised and minor accident and emergency departments.
确定英格兰和威尔士急诊部门执业护士计划的分布及范围；描述医生和执业护士在两个代表性日期的工作量；并估算截至1991年3月31日这一年中由执业护士管理的患者数量。
对急诊部门进行邮政调查，并对两个日期到具有代表性的急诊部门样本就诊的新患者病历进行内容分析。
英格兰和威尔士的所有急诊部门。
560名急诊部门的主管护士。普查对象：37个急诊部门的5814名患者的病历。
设有执业护士计划的急诊部门数量。普查内容：就诊新患者的人口统计学和临床特征，以及诊断、检查、治疗、转诊、出院是由执业护士还是医生进行的。
来自465个仍在运营的急诊部门和48个最近关闭部门的513份回复（92%）。27个（6%）部门使用指定执业护士，159个（34%）部门使用“非官方”执业护士。在普查的5814名患者中，只有530名（9%）完全或主要由执业护士管理，眼科部门（近30%）和轻伤科室（超过40%）的比例高于主要科室（3%）。由执业护士管理的大多数患者（86%）有轻度创伤。在截至1991年3月31日的这一年中，在总共1250万患者（3.1%，2.1%至4.1%）中，估计有390000名（95%置信区间260000至520000）患者由执业护士进行临床管理。
指定执业护士计划很少见。与专科和轻伤急诊部门相比，主要综合急诊部门执业护士的工作量和范围较小。
