St George Hospital Trauma Department, Kogarah, NSW, Australia; The Wollongong Hospital Emergency Department, Wollongong, NSW, Australia; Sydney Nursing School, University of Sydney, Sydney, NSW , Australia.
J Clin Nurs. 2013 Nov;22(21-22):2991-3005. doi: 10.1111/jocn.12226. Epub 2013 May 9.
To evaluate structured patient assessment frameworks' impact on patient care.
Accurate patient assessment is imperative to determine the status and needs of the patient and the delivery of appropriate patient care. Nurses must be highly skilled in conducting timely and accurate patient assessments to overcome environmental obstacles and deliver quality and safe patient care. A structured approach to patient assessment is widely accepted in everyday clinical practice, yet little is known about the impact structured patient assessment frameworks have on patient care.
Integrative review.
An electronic database search was conducted using Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System, PubMed and ProQuest Dissertations and Theses. The reference sections of textbooks and journal articles on patient assessment were manually searched for further studies. A comprehensive peer review screening process was undertaken. Research studies were selected that evaluated the impact structured patient assessment frameworks have on patient care. Studies were included if frameworks were designed for use by paramedics, nurses or medical practitioners working in prehospital or acute in-hospital settings.
Twelve studies met the inclusion criteria. There were no studies that evaluate the impact of a generic nursing assessment framework on patient care. The use of a structured patient assessment framework improved clinician performance of patient assessment. Limited evidence was found to support other aspects of patient care including documentation, communication, care implementation, patient and clinician satisfaction, and patient outcomes.
Structured patient assessment frameworks enhance clinician performance of patient assessment and hold the potential to improve patient care and outcomes; however, further research is required to address these evidence gaps, particularly in nursing.
Acute care clinicians should consider using structured patient assessment frameworks in clinical practice to enhance their performance of patient assessment.
评估结构化患者评估框架对患者护理的影响。
准确的患者评估对于确定患者的状况和需求以及提供适当的患者护理至关重要。护士必须具备及时准确地进行患者评估的高超技能,以克服环境障碍并提供优质安全的患者护理。结构化的患者评估方法在日常临床实践中得到广泛认可,但对于结构化患者评估框架对患者护理的影响知之甚少。
综合审查。
使用 Cumulative Index to Nursing and Allied Health Literature、Medical Literature Analysis and Retrieval System、PubMed 和 ProQuest Dissertations and Theses 进行电子数据库搜索。手动搜索教科书和关于患者评估的期刊文章的参考文献部分以查找其他研究。进行了全面的同行评审筛选过程。选择评估结构化患者评估框架对患者护理影响的研究。如果框架是为在院前或急性院内环境中工作的护理人员、护士或医疗从业者设计的,则纳入研究。
符合纳入标准的研究有 12 项。没有研究评估通用护理评估框架对患者护理的影响。使用结构化患者评估框架可提高临床医生进行患者评估的能力。有限的证据支持患者护理的其他方面,包括文档记录、沟通、护理实施、患者和临床医生满意度以及患者结果。
结构化患者评估框架增强了临床医生对患者评估的表现,并有可能改善患者护理和结果;然而,需要进一步研究来解决这些证据差距,特别是在护理方面。
急性护理临床医生应考虑在临床实践中使用结构化患者评估框架来提高其患者评估能力。