Norris Tracey, Melby Vidar
Tyrone County Hospital, Omagh, N. Ireland.
J Clin Nurs. 2006 Mar;15(3):253-63. doi: 10.1111/j.1365-2702.2006.01306.x.
This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom.
Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom.
A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units.
Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner.
Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner.
Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice. As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing.
本研究探讨了在英国急诊科工作的护士和医生对急性护理执业护士服务发展的看法。
在美国和加拿大进行的研究表明，急性护理执业护士可以对急诊科危重病或受伤患者的就医体验产生积极影响。这一角色在美国和加拿大发展得很好，但在英国仍处于起步阶段。
采用了一种描述性、探索性设计，包括问卷调查（n = 98）和半结构化访谈（n = 6）。样本包括来自七个急诊科和轻伤科室的护士和医生。
受访者认为急性护理执业护士获得专科护士执业资格很重要，并且急性护理执业护士应保留临床职责。虽然参与者似乎对护士进行诸如缝合等传统高级技能操作感到放心，但对其他高级技能如胸腔穿刺术则表现出不情愿。从访谈中确定了三个主要主题：跨专业冲突、自主权以及对急性护理执业护士的需求。
医生不愿意让护士进行某些额外的高级技能操作，困难似乎集中在自主权以及与急性护理执业护士角色相关的其他跨专业冲突上。
护士和医生确定了对急性护理执业护士的需求，但医生和护士之间界限的模糊可能导致跨专业冲突，除非在引入此类高级从业者之前解决这一问题。与临床实践的相关性。随着急诊护士角色的多样化和扩展，本研究重申了在寻求护理角色扩展批准时跨专业合作的重要性。
