Melby Vidar, Ryan Assumpta
Institute of Nursing Research and School of Nursing, University of Ulster, Magee Campus, Derry, UK.
J Clin Nurs. 2005 Oct;14(9):1141-50. doi: 10.1111/j.1365-2702.2005.01222.x.
The aim of this paper is to explore older people's experiences in prehospital emergency care, and identify benefits and difficulties associated with developing a nurse-led ambulance service. Data were collected at sites in Sweden and Norway. Focus group interviews were conducted to enable the collection of data from paramedics, ambulance nurses and nursing students, while individual interviews were utilized to gather data from older people.
There is little research on the quality of care older people over 65 years old receive in prehospital emergency care. Older people often present with multiple pathology and diverse needs that nurses are well equipped to deal with, but presently there is no clearly defined role for nurses in prehospital emergency care in the United Kingdom, although other countries such as Sweden and Norway are developing an ambulance nurse role.
If the multiple needs of older people were addressed in the prehospital field, a reduction in readmissions and increased functional ability might be achieved. Comprehensive training is required for ambulance staff to enable them to meet such needs. While nurses have a great foundation for this care, additional specialist ambulance training is required alongside a need for education on older people's needs and attitudes to older people.
The introduction of ambulance nurses will result in role differentiation between paramedics and ambulance nurses, which has the potential for creating role conflict. To ensure a smooth transition appropriate training and education for nurses and paramedics should be provided. The end result is a potentially greatly enhanced ambulance care provision, enabling high quality care to all patients.
本文旨在探讨老年人在院前急救护理中的经历，并确定与发展由护士主导的救护车服务相关的益处和困难。数据收集于瑞典和挪威的一些地点。开展了焦点小组访谈，以便从护理人员、救护护士和护理专业学生那里收集数据，同时采用个人访谈从老年人那里收集数据。
关于65岁以上老年人在院前急救护理中所接受护理质量的研究很少。老年人常常存在多种病理状况且有多样化的需求，而护士具备处理这些需求的良好能力，但目前在英国，护士在院前急救护理中没有明确界定的角色，尽管瑞典和挪威等其他国家正在发展救护护士这一角色。
如果在院前领域满足老年人的多种需求，或许可以减少再次入院情况并提高功能能力。救护人员需要接受全面培训，以便能够满足此类需求。虽然护士在这种护理方面有很好的基础，但除了需要接受关于老年人需求和对老年人态度的教育外，还需要额外的专业救护培训。
救护护士的引入将导致护理人员和救护护士之间的角色分化，这有可能引发角色冲突。为确保顺利过渡，应为护士和护理人员提供适当的培训和教育。最终结果可能是极大地提升救护车护理服务，为所有患者提供高质量护理。
