Goulburn Valley Health, Shepparton, Victoria, Australia; School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
Australas Emerg Care. 2020 Dec;23(4):233-239. doi: 10.1016/j.auec.2020.03.002. Epub 2020 Jun 16.
Clinical leadership is fundamental to patient safety. The Emergency Department (ED) nurse-in-charge is a key leadership role; however, few studies have explored the management of clinical deterioration from the ED nurse-in-charge perspective. The aim of this study was to explore ED nurses-in-charge' perceptions of their role in responding to episodes of escalation of care for clinical deterioration of ED patients.
A prospective exploratory descriptive design was used to address the study aims. The study was conducted in an urban ED in Melbourne, Australia. Senior emergency nurses who fulfilled the role of being in charge of the ED were invited to participate. In-depth semi-structured interviews were conducted between December 2015 and March 2016. Interview transcripts were analysed using thematic analysis.
Two major themes, each with two subthemes were identified. The first major theme of Clinical Risk Management comprised sub-themes of Clinical Skills and Confidence. The second major theme of Resource Management comprised sub-themes of Human Resource Management and Logistical Resource Management.
Strong collaboration, logistical and clinical risk management roles were perceived as fundamental to the nurse-in-charge's capacity to respond to escalations of care for clinical deterioration within in a complex team environment such as the ED.
临床领导力对于患者安全至关重要。急诊部（ED）主管护士是一个关键的领导角色；然而，很少有研究从 ED 主管护士的角度探讨对临床恶化的管理。本研究旨在探讨 ED 主管护士对其在应对 ED 患者临床恶化的护理升级事件中的角色的看法。
采用前瞻性探索性描述性设计来解决研究目的。该研究在澳大利亚墨尔本的一个城市 ED 进行。邀请符合 ED 主管职责的高级急诊护士参与。2015 年 12 月至 2016 年 3 月期间进行了深入的半结构式访谈。使用主题分析对访谈记录进行分析。
确定了两个主要主题，每个主题都有两个子主题。第一个主要主题为临床风险管理，包括临床技能和信心两个子主题。第二个主要主题为资源管理，包括人力资源管理和后勤资源管理两个子主题。
在 ED 等复杂团队环境中，主管护士被认为需要具备强大的协作、后勤和临床风险管理能力，以应对临床恶化的护理升级事件。
