护士主导的澳大利亚农村急救中心夜间急诊后医疗服务模式：卫生服务利益相关者的看法。
Nurse practitioner led model of after-hours emergency care in an Australian rural urgent care Centre: health service stakeholder perceptions.
机构信息
La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, PO Box 199, Bendigo, Victoria, 3552, Australia.
La Trobe Rural Health School, Violet Vines Marshman Centre for Rural Health Research, La Trobe University, PO Box 199, Bendigo, Victoria, 3552, Australia.
出版信息
BMC Health Serv Res. 2021 Aug 15;21(1):819. doi: 10.1186/s12913-021-06864-9.
BACKGROUND
The challenges of providing and accessing quality health care in rural regions have long been identified. Innovative solutions are not only required but are also vital if effective, timely and equitable access to sustainable health care in rural communities is to be realised. Despite trial implementation of some alternative models of health care delivery, not all have been evaluated and their impacts are not well understood. The aim of this study was to explore the views of staff and stakeholders of a rural health service in relation to the implementation of an after-hours nurse practitioner model of health care delivery in its Urgent Care Centre.
METHODS
This qualitative study included semi-structured individual and group interviews with professional stakeholders of a rural health service in Victoria, Australia and included hospital managers and hospital staff who worked directly or indirectly with the after-hours NPs in addition to local GPs, GP practice nurses, and paramedics. Thematic analysis was used to generate key themes from the data.
RESULTS
Four themes emerged from the data analysis: transition to change; acceptance of the after-hours nurse practitioner role; workforce sustainability; and rural context.
CONCLUSIONS
This study suggests that the nurse practitioner-led model is valued by rural health practitioners and could reduce the burden of excessive after-hour on-call duties for rural GPs while improving access to quality health care for community members. As pressure on rural urgent care centres further intensifies with the presence of the COVID-19 pandemic, serious consideration of the nurse practitioner-led model is recommended as a desirable and effective alternative.
背景
长期以来，农村地区提供和获得高质量医疗保健服务的挑战一直存在。不仅需要创新的解决方案，而且如果要实现农村社区可持续医疗保健的有效、及时和公平获取，这些解决方案也是至关重要的。尽管已经试行过一些替代的医疗服务提供模式，但并非所有模式都经过了评估，其影响也不为人所理解。本研究的目的是探讨农村卫生服务机构工作人员和利益攸关方对其急症护理中心实施非工作时间执业护师医疗服务模式的看法。
方法
本定性研究包括对澳大利亚维多利亚州农村卫生服务机构的专业利益攸关方进行半结构化的个人和小组访谈，访谈对象包括医院管理人员和直接或间接与非工作时间执业护师合作的医院工作人员，以及当地全科医生、全科医生诊所护士和护理人员。采用主题分析从数据中生成关键主题。
结果
数据分析中出现了四个主题：向变革过渡；接受非工作时间执业护师的角色；劳动力可持续性；以及农村背景。
结论
这项研究表明，执业护师主导的模式受到农村卫生从业者的重视，同时可以减轻农村全科医生过度夜间值班的负担，改善社区成员获得高质量医疗保健的机会。随着 COVID-19 大流行对农村急症护理中心的压力进一步加剧，建议认真考虑采用执业护师主导的模式作为一种理想和有效的替代方案。
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