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急诊外科团队——急诊护理的未来之路?

The emergency surgical team - the way forward in emergency care?

作者信息

Tincknell Laura, Burton Sarah, Cooke Claire, Black Stephen, Andreani Stefano, Jourdan Iain, Gudgeon Mark

机构信息

Department of Colorectal Surgery, Frimley Park Hospital, Frimley, Surrey, UK.

出版信息

Ann R Coll Surg Engl. 2009 Jan;91(1):18-22. doi: 10.1308/rcsann.2009.91.1.18.

Abstract

INTRODUCTION

With reduced working hours and shift patterns, surgical training and continuity of patient care is being put at risk. We have devised a system for managing the emergency surgical patients in an effort to counteract these perceived problems. This study describes the emergency surgical team and audits its activity.

PATIENTS AND METHODS

The emergency surgery team concept is described in detail. Over a 2-week period, general surgical referral data, patient management and operative activity were audited.

RESULTS

A total of 229 patients were referred to the emergency surgical team with 159 treated conservatively, 45 underwent operative intervention and 25 were discharged without admission. Of the emergency surgical team referrals, 58% had gallstone pathology, appendicitis or constipation/non-specific abdominal pain. Average daily number of patients under the care of the emergency surgical team was 26 (range, 10-40).

CONCLUSIONS

The consultant-led emergency surgical team look after many of the acutely sick surgical patients. Our system not only provides good teaching opportunities but ensures optimal continuity of patient care in a busy district general hospital. Such an approach to emergency surgical care has been successfully developed to optimise training opportunities and improve patient care in a setting of reduced working hours and shift systems in our hospital.

摘要

引言

随着工作时间的减少和轮班模式的出现,外科培训以及患者护理的连续性正面临风险。我们设计了一个管理急诊外科患者的系统,以应对这些明显的问题。本研究描述了急诊外科团队并审核了其活动。

患者与方法

详细描述了急诊手术团队的概念。在为期2周的时间里,对普通外科转诊数据、患者管理和手术活动进行了审核。

结果

共有229名患者被转诊至急诊外科团队,其中159名接受了保守治疗,45名接受了手术干预,25名未住院就出院了。在急诊外科团队的转诊患者中,58%患有胆结石、阑尾炎或便秘/非特异性腹痛。急诊外科团队护理的患者平均每日数量为26名(范围为10 - 40名)。

结论

由顾问主导的急诊外科团队负责照料许多急重病外科患者。我们的系统不仅提供了良好的教学机会,还确保了繁忙的地区综合医院中患者护理的最佳连续性。在我院工作时间减少和实行轮班制度的情况下,这种急诊外科护理方法已成功开发,以优化培训机会并改善患者护理。

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