Harley A, Johnston A N B, Denny K J, Keijzers G, Crilly J, Massey D
Department of Emergency Medicine, Gold Coast Health, Southport 4215, QLD, Australia; Statewide Paediatric Sepsis Clinical Nurse Consultant: Critical Care Management Team, Queensland Children's Hospital, Brisbane 4101, QLD, Australia.
Department of Emergency Medicine, Gold Coast Health, Southport 4215, QLD, Australia; Department of Emergency Medicine, Princess Alexandra Hospital Metro South Health, Brisbane 4102, QLD, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, Woolloongabba 4102, QLD, Australia.
Int Emerg Nurs. 2019 Mar;43:106-112. doi: 10.1016/j.ienj.2019.01.005. Epub 2019 Feb 4.
Sepsis is a significant and time-sensitive clinical concern for patients who present to Emergency Departments (EDs). Existing guidelines do not define nurses' roles in managing sepsis. This study explored ED nurses' experiences and perceptions around recognising and responding to patients with sepsis, and their awareness of sepsis screening and prognostic tools. The knowledge and insights gained from this study may be used to inform local and international ED policies, and enrich nursing educational packages that may be used to improve quality of patient care and patient outcomes.
Qualitative design incorporating semi-structured interviews with 14 ED nurses was undertaken. Thematic and consensus-based content analyses were used to explore transcripts.
Six key themes were identified; (1) contribution of the organisation, (2) appreciation of knowledge, (3) appreciation of clinical urgency, (4) appreciation of importance of staff supervision, (5) awareness of the importance of staff experience, and (6) awareness of the need to seek advice.
ED nurses' identified deficits in their capacity to recognise and respond to patients with sepsis, despite their vital role within the multidisciplinary team that cares for patients with sepsis. The knowledge and insights gained from this study can be used to inform ED policies, to enrich context-specific educational packages that aim to improve quality of patient care and outcomes and identify areas for further research. Development and implementation of a nurse-inclusive sepsis pathway may address many deficits identified in this study.
对于前往急诊科(ED)就诊的患者而言,脓毒症是一个重大且具有时间敏感性的临床问题。现有指南未明确护士在脓毒症管理中的角色。本研究探讨了急诊科护士在识别和应对脓毒症患者方面的经验和看法,以及他们对脓毒症筛查和预后工具的认识。从本研究中获得的知识和见解可用于为本地和国际急诊科政策提供参考,并丰富可用于提高患者护理质量和改善患者预后的护理教育资料包。
采用定性设计,对14名急诊科护士进行半结构式访谈。运用主题分析和基于共识的内容分析法对访谈记录进行探究。
确定了六个关键主题;(1)组织的贡献,(2)对知识的重视,(3)对临床紧迫性的重视,(4)对员工监督重要性的重视,(5)对员工经验重要性的认识,以及(6)对寻求建议必要性的认识。
尽管急诊科护士在脓毒症患者多学科护理团队中发挥着至关重要的作用,但他们认识到自身在识别和应对脓毒症患者能力方面存在不足。本研究获得的知识和见解可用于为急诊科政策提供参考,丰富旨在提高患者护理质量和改善预后的特定情境教育资料包,并确定进一步研究的领域。制定并实施包含护士的脓毒症护理路径可能会解决本研究中发现的许多不足之处。