Roberts Eric, Velsor-Friedrich Barbara, Keough Vicki
Marcella Niefhoff School of Nursing, Loyola University Chicago, Maywood, Illinois.
Adv Emerg Nurs J. 2018 Jan/Mar;40(1):45-58. doi: 10.1097/TME.0000000000000177.
Patients often present to emergency departments (EDs) for the management of chronic asthma. Because of the nature of ED care, national guideline recommendations for asthma education are generally not initiated in the ED. There is evidence that asthma education can have a positive effect on patient outcomes (; ). This study examines the feasibility of implementing an asthma self-management guideline in a tertiary care center ED. Despite protocol utilization by physicians (87%), nurse practitioners and physician assistants (66.7%), and nurses (41.7%), total compliance with national guideline was accomplished in only 25.93% of cases. Barriers to protocol implementation included staff education, high workload, rapid turnover, and competing initiatives within the department. Linear regression analysis identified high daily census as a predictor of protocol noncompliance (p = 0.033).
患者常因慢性哮喘的治疗而前往急诊科。由于急诊科护理的性质,哮喘教育的国家指南建议通常不在急诊科启动。有证据表明哮喘教育可对患者预后产生积极影响(;)。本研究考察了在三级医疗中心急诊科实施哮喘自我管理指南的可行性。尽管医生(87%)、执业护士和医师助理(66.7%)以及护士(41.7%)都使用了该方案,但仅25.93%的病例完全符合国家指南。方案实施的障碍包括员工教育、工作量大、人员流动快以及部门内相互竞争的举措。线性回归分析确定每日高就诊人数是方案不依从的一个预测因素(p = 0.033)。