Henneman P L, Hockberger R S, Chiu C Y
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.
Ann Emerg Med. 1989 Jan;18(1):34-41. doi: 10.1016/s0196-0644(89)80308-7.
We surveyed the 66 accredited emergency medicine residency programs in the United States during 1986 on the issue of attending coverage. Responses were received from 411 residents and 288 faculty; this accounted for 42% of the residents and 56% of the faculty from the 56 responding programs. Seventy-three percent of emergency medicine residency programs had 24-hour attending coverage. According to residents, faculty from programs with 24-hour coverage spent a greater percentage of their shift doing primary patient care than faculty from programs without 24-hour coverage (35% vs 17%, respectively, P less than .0001), and a smaller percentage of their shift educating residents (21% vs 30%, respectively, P less than .0001). Ninety-five percent of faculty and 71% of residents thought that the quality of patient care was better when faculty were present in the ED (P less than .0001). Sixty-one percent of residents and 60% of faculty did not think that 24-hour attending coverage in academic emergency medicine should be mandated. The impact of night-time attending coverage in emergency medicine residency programs on patient care, resident education, and faculty development is unclear and minimally studied.
1986年，我们就主治医生值班覆盖情况这一问题，对美国66个经认可的急诊医学住院医师培训项目进行了调查。收到了411名住院医师和288名教员的回复；这占了56个回复项目中住院医师的42%和教员的56%。73%的急诊医学住院医师培训项目有24小时主治医生值班覆盖。据住院医师反映，有24小时覆盖的项目的教员在轮班期间用于直接患者护理的时间比例，高于没有24小时覆盖的项目的教员（分别为35%和17%，P<0.0001），而用于指导住院医师的时间比例则较小（分别为21%和30%，P<0.0001）。95%的教员和71%的住院医师认为，当教员在急诊科时，患者护理质量更高（P<0.0001）。61%的住院医师和60%的教员认为，学术性急诊医学中不应强制要求24小时主治医生值班覆盖。急诊医学住院医师培训项目中的夜间主治医生值班覆盖对患者护理、住院医师教育和教员发展的影响尚不清楚，且研究极少。
