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农村偏远地区的分诊教育:一项范围综述。

Triage education in rural remote settings: A scoping review.

作者信息

Hardy Amber, Calleja Pauline

机构信息

Emergency Department, Mackay Hospital and Health Service, Queensland Health, 475 Bridge Road, Mackay, QLD 4740, Australia.

School of Nursing & Midwifery, and Menzies Health Institute Queensland, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia.

出版信息

Int Emerg Nurs. 2019 Mar;43:119-125. doi: 10.1016/j.ienj.2018.09.001. Epub 2018 Nov 10.

Abstract

BACKGROUND

Triage is a complex nursing task to prioritise patient care, based on acuity. Triage decisions can affect patient safety and must employ critical thinking. Graduate registered nurses are expected to triage in rural facilities, which is in contrast to current guidelines. The purpose of this review was; to discover how effective education support programs were in developing clinical decision-making skills for graduates at triage; and to determine what is known about triage education support programs for graduate or novice registered nurses undertaking triage in rural and remote settings.

METHOD

A scoping review was undertaken to identify and analyse primary research articles following PRISMA guidelines, sourced from four electronic databases.

RESULTS

6158 retrieved articles were found, after duplicate removal and screening against inclusion/exclusion criteria; fourteen articles were included. Themes included 'variability of triage accuracy and assessment'; 'education qualifications and experience'; and 'training and supervision'.

CONCLUSION

This review demonstrates significant gaps in the literature reporting on this topic area, particularly in the rural context. Common recommendations include standardised triage education strategies, and strategies that account for differences in resourcing levels. Further research is required to attempt to link education strategies in rural contexts to acceptable triage outcomes like triage accuracy.

摘要

背景

分诊是一项复杂的护理任务,需根据病情严重程度对患者护理进行优先排序。分诊决策会影响患者安全,且必须运用批判性思维。预计注册护士毕业生要在农村医疗机构进行分诊,这与当前指南相悖。本综述的目的是:了解教育支持项目在培养毕业生分诊临床决策技能方面的效果如何;以及确定对于在农村和偏远地区进行分诊的注册护士毕业生或新手,有关分诊教育支持项目的已知情况。

方法

按照PRISMA指南进行范围综述,以识别和分析来自四个电子数据库的原始研究文章。

结果

在去除重复文章并根据纳入/排除标准进行筛选后,共检索到6158篇文章;纳入了14篇文章。主题包括“分诊准确性和评估的可变性”“教育资质和经验”以及“培训与监督”。

结论

本综述表明该主题领域的文献报道存在显著差距,尤其是在农村背景下。常见建议包括标准化分诊教育策略以及考虑资源水平差异的策略。需要进一步研究,尝试将农村背景下的教育策略与可接受的分诊结果(如分诊准确性)联系起来。

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