Fanta Kaaren, Cook Becky, Falcone Richard A, Rickets Crystal, Schweer Lynn, Brown Rebeccah L, Garcia Victor F
Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
J Pediatr Surg. 2006 Jan;41(1):277-81. doi: 10.1016/j.jpedsurg.2005.10.049.
Work hour restrictions for house staff have forced a reevaluation of the traditional roles of all health care providers. In 2001, our level I pediatric trauma center augmented the role of our trauma pediatric nurse practitioners (PNPs) to include in-patient management. We hypothesized that a PNP can provide injured children a level of care commensurate with a resident (RES).
All children between 2 months and 17 years old admitted to the Trauma Service were considered for the study. Patients were randomized to PNP or RES care groups. Types of injuries, injury severity score, missed injuries, readmissions, hospital length of stay (LOS), and cost were recorded. Satisfaction surveys were administered to all families.
A total of 76 children were enrolled. During the study period, there were no missed injuries or readmissions. The PNP group had a significantly shorter LOS and received significantly higher satisfaction survey scores with regard to information on injuries, tests and treatment, and frequency of visits provided to the patient/family.
PNPs provide equivalent care for injured children with significantly shorter LOS and higher patient satisfaction than RESs. In-patient trauma nurse practitioners provide added value to the care of the injured child in the era of reduced RES work hours.
对住院医生工作时间的限制促使人们重新审视所有医疗服务提供者的传统角色。2001年，我们的一级儿科创伤中心扩大了创伤儿科护士从业者（PNP）的职责范围，将住院患者管理纳入其中。我们假设PNP能够为受伤儿童提供与住院医师（RES）相当的护理水平。
所有入住创伤科的2个月至17岁儿童均纳入本研究。患者被随机分为PNP护理组或RES护理组。记录损伤类型、损伤严重程度评分、漏诊损伤、再入院情况、住院时间（LOS）和费用。对所有家庭进行满意度调查。
共纳入76名儿童。在研究期间，没有漏诊损伤或再入院情况。PNP组的住院时间显著缩短，在关于损伤、检查和治疗的信息以及对患者/家庭的探访频率方面，满意度调查得分显著更高。
PNP为受伤儿童提供同等护理，与RES相比，住院时间显著缩短，患者满意度更高。在RES工作时间减少的时代，住院创伤护士从业者为受伤儿童的护理增添了价值。
