Fry Margaret, Ruperto Kate, Jarrett Kate, Wheeler Janet, Fong Jacqueline, Fetchet Wendy
Faculty of Nursing, Midwifery and Health University of Technology, Sydney, Australia.
Australas Emerg Nurs J. 2012 Nov;15(4):202-10. doi: 10.1016/j.aenj.2012.10.003.
The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests and treat and manage a range of patient conditions. In 2010, the New South Wales Ministry of Health redefined the focus of the CIN role to be on waiting room patients. The new CIN role was now focused on the waiting room and to 'communicate the wait', initiate diagnostics and or treatment and follow-up for waiting room patients. While new models of care are often introduced the perceptions of those undertaking the roles are often absent from evaluation. We aimed to explore emergency nurses' perceptions of the extended practice role known as the Clinical Initiative Nurse.
This was a multicentre study and formed part of a larger qualitative exploratory study of the CIN role.
Thirty-six interviews were conducted across the three sites. There was no statistical difference between groups for hospital site, ED experience or Clinical Nurse Specialist grade. Three main themes were identified from the data and included (i) managing the waiting room patient; (ii) benefits of being the CIN; and (iii) situational barriers impacting on the CIN role.
We have provided a deeper understanding of the CIN role and of contextual factors operating in everyday practice. Further research is needed to determine how nursing roles can be sustained, learned, enjoyed and optimised to meet future healthcare goals.
临床倡议护士（CIN）这一角色要求经验丰富的急诊科护士对一系列患者病情进行评估、启动诊断测试以及治疗和管理。2010年，新南威尔士州卫生部将CIN角色的重点重新定义为关注候诊室患者。新的CIN角色现在聚焦于候诊室，并负责“告知等待情况”，为候诊室患者启动诊断和/或治疗以及跟进。虽然新的护理模式经常被引入，但对承担这些角色的人员的看法往往在评估中缺失。我们旨在探讨急诊科护士对被称为临床倡议护士的扩展实践角色的看法。
这是一项多中心研究，是对CIN角色进行的一项更大规模定性探索性研究的一部分。
在三个地点共进行了36次访谈。各医院地点、急诊科工作经验或临床护士专家级别在组间无统计学差异。从数据中确定了三个主要主题，包括（i）管理候诊室患者；（ii）担任CIN的益处；以及（iii）影响CIN角色的情境障碍。
我们对CIN角色以及日常实践中的背景因素有了更深入的理解。需要进一步研究以确定如何维持、学习、享受并优化护理角色，以实现未来的医疗保健目标。
