“4小时目标”：急诊护士的观点
The "4-hour target": emergency nurses' views.
作者信息
Mortimore Andy, Cooper Simon
机构信息
Emergency Department, Torbay Hospital, Lawes Bridge, Torquay, Devon, TQ2 7AA, UK.
出版信息
Emerg Med J. 2007 Jun;24(6):402-4. doi: 10.1136/emj.2006.044933.
Abstract
OBJECTIVE
To explore nurses' views and to identify the perceived advantages and disadvantages of the "4-hour target."
METHODS
The study was based in one emergency department (ED) in the UK and took a generic qualitative approach. A stratified sample of nine experienced ED nurses were recruited for semi-structured interviews. Data was analysed using the framework analysis approach.
RESULTS
The 4-hour target was considered an overall success in reducing waiting times and increasing patient satisfaction. However, staff expressed concerns over the imposed nature of the target, workload pressures, quality of care, and the level of support from secondary and primary care.
CONCLUSION
Although deemed an overall success, there were reservations as to the target's sustainability. Recommendations are made for improved communication between primary and secondary care and establishing the target as a shared goal within the hospital environment.
摘要
目的
探讨护士的观点，并确定“4小时目标”的感知优势和劣势。
方法
该研究以英国的一个急诊科为基础，采用一般定性研究方法。招募了9名经验丰富的急诊科护士组成分层样本进行半结构化访谈。使用框架分析法对数据进行分析。
结果
4小时目标在减少等待时间和提高患者满意度方面被认为总体上是成功的。然而，工作人员对目标的强制性、工作量压力、护理质量以及二级和初级护理的支持水平表示担忧。
结论
尽管总体上被认为是成功的，但对于该目标的可持续性存在保留意见。建议改善初级和二级护理之间的沟通，并将该目标确立为医院环境中的共同目标。
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3
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BMA claims that patients in A&E are being put at risk.英国医学协会称，急症室的患者正面临风险。
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