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瑞典院前急救护理专业学生所描述的临床决策制定——一项探索性研究。

Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.

作者信息

Nilsson Tomas, Lindström Veronica

机构信息

Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Academic EMS, Stockholm, Sweden; Falck Ambulance Service, Stockholm, Sweden.

Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Academic EMS, Stockholm, Sweden.

出版信息

Int Emerg Nurs. 2016 Jul;27:46-50. doi: 10.1016/j.ienj.2015.10.006. Epub 2015 Nov 23.

Abstract

AIM

The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services.

INTRODUCTION

Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation.

METHODS

A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis.

FINDINGS

The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses.

CONCLUSION

The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN.

摘要

目的

本研究旨在探讨院前急救护理专业学生在为期七周的急救服务临床实习期间的临床决策情况。

引言

培养院前急救护理实践方面的专业技能需要理论学习和实践经验。院前急救护理人员(PECN)是在急救护理方面接受过一年额外培训的注册护士(RN)。关于PECN专业学生如何描述他们在临床实习期间的决策过程,目前的研究较少。

方法

采用定性研究设计,对瑞典PECN专业学生撰写的12本日志进行内容分析。

结果

学生们记录了他们在临床实习期间遇到的997次患者情况——急救任务。四个主题对于学生的决策至关重要:了解患者、急救服务中的情境意识、协作和评估。基于这些主题,学生们决定如何应对患者的病情。

结论

PECN专业学生在决策过程中考虑了多个变量。决策是整个急救任务过程中的一个持续过程。大学有责任在学生从注册护士向院前急救护理人员转变的过程中给予指导。本研究结果可为教育工作者和临床督导制定成为院前急救护理人员的学习计划提供支持。

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