Emergency Medical Service, RAV Brabant MWN, 's-Hertogenbosch, Brabant, 5212VM, The Netherlands.
Research Department of Emergency and Critical Care, HAN University of Applied Science, School of Health Studies, Nijmegen, Gelderland, 6525 EJ, The Netherlands.
F1000Res. 2020 Sep 29;9:1182. doi: 10.12688/f1000research.25891.1. eCollection 2020.
: This review aims to describe the activities of nurse practitioners (NPs) and physician assistants (PAs) working in ambulance care, and the effect of these activities on patient outcomes, process of care, provider outcomes, and costs. : PubMed, MEDLINE (EBSCO), EMBASE (OVID), Web of Science, the Cochrane Library (Cochrane Database of Systematic Review), CINAHL Plus, and the reference lists of the included articles were systematically searched in November 2019. All types of peer-reviewed designs on the three topics were included. Pairs of independent reviewers performed the selection process, the quality assessment, and the data extraction. : Four studies of moderate to poor quality were included. Activities in medical, communication and collaboration skills were found. The effects of these activities were found in process of care and resource use outcomes, focusing on non-conveyance rates, referral and consultation, on-scene time, or follow-up contact s: This review shows that there is limited evidence on activities of NPs and PAs in ambulance care. Results show that NPs and PAs in ambulance care perform activities that can be categorized into the Canadian Medical Education Directives for Specialists (CanMED) roles of Medical Expert, Communicator, and Collaborator. The effects of NPs and PAs are minimally reported in relation to process of care and resource use, focusing on non-conveyance rates, referral and consultation, on-scene time, or follow-up contact. No evidence on patient outcomes of the substitution of NPs and PAs in ambulance care exists. : CRD42017067505 (07/07/2017).
本综述旨在描述在救护车上工作的执业护士（NPs）和医师助理（PAs）的活动，以及这些活动对患者结局、护理过程、提供者结局和成本的影响。我们于 2019 年 11 月系统地检索了 PubMed、MEDLINE（EBSCO）、EMBASE（OVID）、Web of Science、Cochrane 图书馆（Cochrane 系统评价数据库）、CINAHL Plus 和纳入文章的参考文献列表。纳入了关于这三个主题的所有类型的同行评议设计。由两名独立评审员进行选择过程、质量评估和数据提取。纳入了四项质量为中等或较差的研究。发现了医疗、沟通和协作技能方面的活动。这些活动的效果在护理过程和资源使用结果中发现，重点是不转院率、转诊和咨询、现场时间或随访接触。本综述表明，关于救护车上 NPs 和 PAs 的活动，证据有限。结果表明，救护车上的 NPs 和 PAs 执行的活动可以归类为加拿大医学教育专家指令（CanMED）的医疗专家、沟通者和协作者角色。关于患者结局，NPs 和 PAs 的替代作用在救护车上的证据很少，主要集中在不转院率、转诊和咨询、现场时间或随访接触方面。关于在救护车上替代 NPs 和 PAs 的患者结局的证据尚不存在。CRD42017067505（2017 年 7 月 7 日）。
