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文献回顾:影响护士有效使用医疗应急团队(MET)的因素。

A literature review: factors that impact on nurses' effective use of the Medical Emergency Team (MET).

机构信息

Flinders Medical Centre, Adelaide, SA, Australia.

出版信息

J Clin Nurs. 2009 Dec;18(24):3379-90. doi: 10.1111/j.1365-2702.2009.02944.x.

Abstract

AIMS AND OBJECTIVES

The aim of this literature review is to identify factors, both positive and negative, that impact on nurses' effective use of the Medical Emergency Team (MET) in acute care settings.

BACKGROUND

Outcomes for patients are often dependent on nurses' ability to identify and respond to signs of increasing illness and initiate medical intervention. In an attempt to improve patient outcomes, many acute hospitals have implemented a rapid response system known as the Medical Emergency Team (MET) which has improved management of critically ill ward patients. Subsequent research has indicated that the MET system continues to be underused by nurses.

DESIGN

A comprehensive thematic literature review.

METHODS

The review was undertaken using key words and the electronic databases of Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID/MEDLINE, Blackwell Synergy, Science Direct and Informit. Fifteen primary research reports were relevant and included in the review.

RESULTS

Five major themes emerged from the analysis of the literature as the major factors effecting nurses' use of the MET system. They were: education on the MET, expertise, support by medical and nursing staff, nurses' familiarity with and advocacy for the patient and nurses' workload.

CONCLUSIONS

Ongoing education on all aspects of the MET system is recommended for nursing, medical and MET staff. Bringing MET education into undergraduate programs to prepare new graduates entering the workforce to care for acutely ill patients is also strongly recommended. Further research is also needed to determine other influences on MET activation. Relevance to clinical practice. Strategies that will assist nurses to use the MET system more effectively include recruitment and retention of adequate numbers of permanent skilled staff thereby increasing familiarity with and advocacy for the patient. Junior doctors and nurses should be encouraged to attend ward MET calls to gain skills in management of acutely ill patients.

摘要

目的和目标

本文献综述的目的是确定积极和消极两个方面的因素,这些因素会影响护士在急性护理环境中有效使用医疗应急小组(MET)。

背景

患者的结果往往取决于护士识别和应对疾病加重迹象以及启动医疗干预的能力。为了改善患者的结果,许多急性医院已经实施了一种称为医疗应急小组(MET)的快速反应系统,该系统改善了对重症病房患者的管理。随后的研究表明,护士对 MET 系统的使用仍然不足。

设计

全面的主题文献综述。

方法

该综述使用关键词和 Cumulative Index to Nursing and Allied Health Literature(CINAHL)、OVID/MEDLINE、Blackwell Synergy、Science Direct 和 Informit 等电子数据库进行。有 15 篇主要研究报告与综述相关并被纳入。

结果

从文献分析中出现了五个主要主题,这些主题是影响护士使用 MET 系统的主要因素。它们是:MET 系统的教育、专业知识、医疗和护理人员的支持、护士对患者的熟悉程度和倡导以及护士的工作量。

结论

建议对护理、医疗和 MET 人员进行 MET 系统各方面的持续教育。强烈建议将 MET 教育纳入本科课程,为即将进入工作岗位照顾急性病患者的新毕业生做好准备。还需要进一步研究确定对 MET 激活的其他影响。与临床实践的相关性。有助于护士更有效地使用 MET 系统的策略包括招聘和留住足够数量的固定熟练人员,从而增加对患者的熟悉程度和倡导。应鼓励初级医生和护士参加病房 MET 呼叫,以获得管理急性病患者的技能。

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