Cabilan C J, Boyde Mary
Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Australia.
Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
Australas Emerg Nurs J. 2017 May;20(2):53-62. doi: 10.1016/j.aenj.2017.04.001. Epub 2017 Apr 25.
Nurse-initiated medications are one of the most important strategies used to facilitate timely care for people who present to Emergency Departments (EDs). The purpose of this paper was to systematically review the evidence of nurse-initiated medications to guide future practice and research.
A systematic review of the literature was conducted to locate published studies and Grey literature. All studies were assessed independently by two independent reviewers for relevance using titles and abstracts, eligibility dictated by the inclusion criteria, and methodological quality.
Five experimental studies were included in this review: one randomised controlled trial and four quasi-experimental studies conducted in paediatric and adult EDs. The nurse-initiated medications were salbutamol for respiratory conditions and analgesia for painful conditions, which enabled patients to receive the medications quicker by half-an-hour compared to those who did not have nurse-initiated medications. The intervention had no effect on adverse events, doctor wait time and length of stay. Nurse-initiated analgesia was associated with increased likelihood of receiving analgesia, achieving clinically-relevant pain reduction, and better patient satisfaction.
Nurse-initiated medications are safe and beneficial for ED patients. However, randomised controlled studies are required to strengthen the validity of results.
护士发起的药物治疗是用于为前往急诊科（ED）的患者提供及时护理的最重要策略之一。本文的目的是系统回顾护士发起的药物治疗的证据，以指导未来的实践和研究。
对文献进行系统回顾以查找已发表的研究和灰色文献。由两名独立的评审员使用标题和摘要对所有研究进行独立评估，以确定其相关性、纳入标准规定的合格性以及方法学质量。
本综述纳入了五项实验性研究：一项随机对照试验和四项在儿科和成人急诊科进行的准实验性研究。护士发起的药物治疗包括用于呼吸系统疾病的沙丁胺醇和用于疼痛状况的镇痛药物，与未接受护士发起药物治疗的患者相比，这使得患者能够更快半小时接受药物治疗。该干预对不良事件、医生等待时间和住院时间没有影响。护士发起的镇痛与接受镇痛的可能性增加、实现临床相关的疼痛减轻以及更高的患者满意度相关。
护士发起的药物治疗对急诊科患者是安全且有益的。然而，需要进行随机对照研究以加强结果的有效性。
