执业护士管理的胸痛评估单元的有效性及结果
Effectiveness and outcomes of a nurse practitioner-run chest pain evaluation unit.
作者信息
Zhu Zahra, Islam Sirajul, Bergmann Steven R
机构信息
Thomas Killip Division of Cardiology, Department of Medicine, Mount Sinai Beth Israel Medical Center, New York.
Department of Medicine, The Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut.
出版信息
J Am Assoc Nurse Pract. 2016 Nov;28(11):591-595. doi: 10.1002/2327-6924.12377. Epub 2016 May 19.
BACKGROUND
Every year, more than 5 million patients seek medical care for chest pain.
OBJECTIVE
The goal of this study was to evaluate test utilization and outcomes of a nurse practitioner (NP)-based chest pain unit and compare results to data previously reported from our institution.
DESIGN, SETTING, AND PARTICIPANTS: The records from 814 consecutive patients with chest pain admitted to the NP-run unit were compared to the outcomes of 250 patients admitted to a separate hospitalist-run unit at a New York City hospital.
RESULTS
Forty-four percent of patients in the NP unit underwent stress myocardial perfusion imaging (MPI) as the primary diagnostic test (compared to 22% in the hospitalist unit, p < .0001). The average length of stay was shorter for patients in the NP unit (2.7 ± 3.6 days compared to 3.9 ± 3.4 days, p < .0001). Additionally, the 90-day readmission rate was less for patients in the NP unit (2.7% vs. 3.9%, p < .0006).
CONCLUSIONS
An NP-run chest pain unit resulted in decreased length of stay and reduced readmission rates compared to a hospitalist-based unit.
背景
每年有超过500万患者因胸痛寻求医疗护理。
目的
本研究的目的是评估基于执业护士（NP）的胸痛单元的检查利用情况和治疗结果，并将结果与我们机构之前报告的数据进行比较。
设计、设置和参与者：将连续收治到NP管理单元的814例胸痛患者的记录与纽约市一家医院单独的住院医师管理单元收治的250例患者的治疗结果进行比较。
结果
NP单元中44%的患者接受了负荷心肌灌注成像（MPI）作为主要诊断检查（相比之下，住院医师单元为22%，p <.0001）。NP单元患者的平均住院时间较短（2.7±3.6天，而住院医师单元为3.9±3.4天，p <.0001）。此外，NP单元患者的90天再入院率较低（2.7%对3.9%，p <.0006）。
结论
与基于住院医师的单元相比，由NP管理的胸痛单元可缩短住院时间并降低再入院率。
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