Princess Margaret Hospital for Children, Child & Adolescent Health Services, GPO Box D184, Perth WA 6840, Australia.
Aust Crit Care. 2012 Nov;25(4):224-37. doi: 10.1016/j.aucc.2011.12.056. Epub 2012 Feb 4.
The aim of this paper is to review the differences and similarities in critical care nursing staffing, education and practice standards in the US, Canada, UK, New Zealand and Australia.
A university library discovery catalogue, Science Direct, Scopus databases and professional websites were searched. Key terms used included, critical care, specialist, standards, competency, practice, scope, workforce, staffing, ratios, qualifications, adverse events, and patient outcomes. The search was limited to articles that referred to critical care environments including paediatric and neonatal settings.
The database and hand search identified 40 relevant articles. Website searching resulted in a further 36 documents. A diversity of critical care nursing contexts and a lack of comparable workforce data made it difficult to quantify differences and similarities between countries. There is a general consensus about the importance of optimum staffing by registered nurses with a proportion of those holding relevant post-registration qualifications although there is no consistency in defining the educational preparation for a 'qualified' critical care nurse. Critical care nursing standards for the US, Canada, UK and New Zealand were predominantly developed by expert panels while the Australian standards were developed with a multi-methods study including observations of practice. All five standards documents were built upon national entry-to-practice nurse standards and contained similar constructs, although there was no construct common to all of the standards.
There is a lack of evidence to support nursing staffing with post registration specialty qualifications. Existing standards are predominantly opinion based rather than supported by research. The expected standards for nursing practice are fundamentally similar.
本文旨在综述美国、加拿大、英国、新西兰和澳大利亚在重症监护护理人员配置、教育和实践标准方面的异同。
在大学图书馆发现目录、Science Direct、Scopus 数据库和专业网站上进行了搜索。使用的关键词包括重症监护、专科、标准、能力、实践、范围、劳动力、人员配置、比例、资质、不良事件和患者结局。检索范围仅限于提到重症监护环境的文章，包括儿科和新生儿环境。
数据库和手工搜索共确定了 40 篇相关文章。网站搜索又产生了 36 份文件。重症监护护理环境的多样性以及劳动力数据缺乏可比性，使得难以量化各国之间的异同。对于注册护士的最佳人员配置（包括一定比例持有相关注册后资质的护士）达成了普遍共识，尽管对于“合格”重症监护护士的教育准备没有一致性定义。美国、加拿大、英国和新西兰的重症监护护理标准主要由专家小组制定，而澳大利亚的标准则是在包括实践观察在内的多方法研究基础上制定的。所有五个标准文件都建立在国家执业护士标准之上，包含相似的结构，尽管并非所有标准都有共同的结构。
没有证据支持具有注册后专业资质的护理人员配置。现有的标准主要是基于意见，而不是基于研究。预期的护理实践标准在根本上是相似的。
