通过横向整合改善患者护理的机遇：临床护理领导者

Begun James W, Tornabeni Jolene, White Kenneth R

Division of Health Services Research and Policy, University of Minnesota, Minneapolis, USA.

J Healthc Manag. 2006 Jan-Feb;51(1):19-25.

Today, healthcare organizations are faced with the growing realization that functional and professional silos within the organization are counter to the provision of efficient and effective patient care and are fertile grounds for errors or sentinel events to occur. The improvement of patient care and prevention of errors require that collaboration among professionals occur at the patient care delivery level, not just within the leadership team. A new nursing role-the clinical nurse leader, the first new nursing role advanced nationally in more than three decades--currently is under development in more than 180 pilot healthcare delivery sites across the United States and Puerto Rico. The clinical nurse leader is a master's-prepared nurse who assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting through the assimilation and application of research-based information to design, implement, and evaluate client plans of care. The clinical nurse leader serves as a lateral integrator for the healthcare team and facilitates, coordinates, and oversees the care provided by the healthcare team. Healthcare administrators should seize the opportunity to work with nurses in healthcare delivery organizations to influence the early evolution and diffusion of this new role.

如今，医疗机构日益意识到，组织内部的职能和专业壁垒不利于提供高效且有效的患者护理，并且是错误或警讯事件发生的滋生地。改善患者护理和预防错误要求专业人员之间的协作不仅要在领导团队内部进行，还要在患者护理服务层面开展。一种新的护理角色——临床护理领导者，这是三十多年来首个在全国范围内得到推进的新护理角色——目前正在美国和波多黎各180多个试点医疗服务机构中进行开发。临床护理领导者是一名拥有硕士学位的护士，通过吸收和应用基于研究的信息来设计、实施和评估患者护理计划，对单位或环境内特定患者群体的医疗结果负责。临床护理领导者作为医疗团队的横向整合者，促进、协调并监督医疗团队提供的护理。医疗管理人员应抓住机会，与医疗服务机构中的护士合作，影响这一新角色的早期发展和推广。