Crouch Robert, Brown Ruth
Consultant Nurse, Emergency Department, University Hospital Southampton NHS Foundation Trust and Honorary Professor of Emergency Care, University of Southampton, Southampton SO16 6YD.
Consultant in Emergency Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London.
Br J Hosp Med (Lond). 2018 Sep 2;79(9):511-515. doi: 10.12968/hmed.2018.79.9.511.
Developing a consistent and skilled workforce is critical to the sustainability of any clinical service. Nurses and paramedics have formed part of the emergency care workforce for many years and the extended role of these staff groups has supported patient care as the demand has risen and outstripped the capacity of the medical staff. In many hospitals and health-care systems, these extended roles have developed in response to local demand and case mix, resulting in inconsistent role descriptions and lack of transportable qualifications. Even for established roles such as emergency nurse practitioners, there is no UK-wide defined scope of practice or curriculum to support the role. In 2014 a joint working group of the Royal College of Emergency Medicine and Health Education England agreed a programme of work to support a sustainable emergency care workforce. One stream of that work focused on developing non-medical roles within emergency care and in particular the role of the advanced clinical practitioner in emergency medicine. Advanced practice has developed in the UK in many specialties and the new advanced practice framework from Health Education England (2017) allows a cross-discipline understanding of the principles and key aspects of advanced practice. However, this framework is naturally generic and does not focus on what a practitioner is capable of within a specific clinical area, but more on the core capabilities. This article outlines the development of a UK-wide curriculum and credentialing process for emergency care advanced clinical practitioners and reports on progress to date.
培养一支稳定且技术娴熟的员工队伍对于任何临床服务的可持续发展至关重要。护士和护理人员多年来一直是急救护理队伍的一部分，随着需求的增加且超过了医务人员的能力，这些员工群体的扩展角色为患者护理提供了支持。在许多医院和医疗保健系统中，这些扩展角色是根据当地需求和病例组合发展起来的，导致角色描述不一致且缺乏可移植的资质。即使对于诸如急诊护士从业者等既定角色，英国也没有全国统一界定的执业范围或课程来支持该角色。2014年，皇家急诊医学院和英格兰健康教育部门的一个联合工作组商定了一项工作计划，以支持可持续的急救护理队伍。该工作的一个方向侧重于在急救护理中发展非医疗角色，特别是急诊医学高级临床从业者的角色。高级实践在英国的许多专业领域都有发展，英格兰健康教育部门（2017年）的新高级实践框架允许对高级实践的原则和关键方面有跨学科的理解。然而，这个框架本质上是通用的，并不专注于从业者在特定临床领域的能力，而是更多地关注核心能力。本文概述了针对急救护理高级临床从业者的全英课程和认证流程的发展情况，并报告了迄今为止的进展。
