Burns Timothy R
Saint Louis University, School of Nursing, 3525 Caroline St, St. Louis, MO 63104, USA.
Int Emerg Nurs. 2017 Nov;35:51-55. doi: 10.1016/j.ienj.2017.06.001. Epub 2017 Jul 1.
Overcrowding in emergency departments is an issue that has a negative impact worldwide. As attendance in emergency departments has increased, the ability to provide critical services to patients suffering from actual medical emergencies in a timely manner has decreased as these departments are many times at or over capacity. One patient population whose negative influence has been researched with regard to their impact on the overcrowding issue is that of the frequent user.
A search of two electronic databases was conducted to identify factors that frequent users state as their reasoning for using an emergency department. Peer reviewed articles in English were searched for in CINAHL Plus and PubMed, as well as a review of reference lists.
A review of the literature identified two predominant factors related to frequent users in the emergency department: a lack of awareness of medical necessity and issues of access.
To address the frequent users in emergency departments, implications for practice need to be explored and implemented. Implications for practice include education of medical necessity for the frequent users, expansion of the pre-hospital role in primary care and inappropriate use prevention, and improvement of access to alternative healthcare services.
急诊科人满为患是一个在全球范围内都有负面影响的问题。随着急诊科就诊人数的增加，由于这些科室多次处于满负荷或超负荷状态，及时为患有实际医疗急症的患者提供关键服务的能力有所下降。在过度拥挤问题方面，其负面影响已得到研究的一类患者群体是频繁就诊者。
对两个电子数据库进行检索，以确定频繁就诊者将其作为使用急诊科理由的因素。在CINAHL Plus和PubMed中检索英文的同行评审文章，并查阅参考文献列表。
文献综述确定了与急诊科频繁就诊者相关的两个主要因素：对医疗必要性缺乏认识和就医渠道问题。
为解决急诊科频繁就诊者的问题，需要探索并实施对实践的启示。对实践的启示包括对频繁就诊者进行医疗必要性教育、扩大初级保健中的院前作用及预防不适当使用，以及改善获得替代医疗服务的途径。
