利用护士导航员护理模式改善囚犯的医疗保健，减少囚犯到三级急诊部门就诊的次数。

Utilising a nurse navigator model of care to improve prisoner health care and reduce prisoner presentations to a tertiary emergency department.

机构信息

Department of Emergency Medicine, Princess Alexandra Hospital, QLD, Australia.

Department of Emergency Medicine, Princess Alexandra Hospital, QLD, Australia; School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, QLD, Australia.

出版信息

Australas Emerg Care. 2022 Dec;25(4):341-346. doi: 10.1016/j.auec.2022.04.004. Epub 2022 May 6.

DOI:10.1016/j.auec.2022.04.004

PMID:35534358

Abstract

BACKGROUND

Prisoners are a vulnerable population requiring complex care interventions in challenging environments, particularly around provision of emergency care. The aim of this study was to explore the effectiveness of a Nurse Navigator (NN) -led prisoner intervention from the perspective of the emergency department.

METHODS

This study undertook a retrospective analysis of the prisoner presentations to a public emergency department. It used time-series analysis of publicly available deidentified data, collected during standard care evaluation, to explore the impact of this unique care model over 24 months (12-pre and 12-post). Synthesis of documents pertaining to this NN model of care provide a summary of key initiatives and interventions.

RESULTS

With the introduction of NN, the rate of change of yearly prisoner presentations dropped from + 32.8% to - 2.7%. Interrupted time-series analysis on emergency department presentations per 1000 prisoners in custody confirmed a postintervention level drop of 15.1% (rate ratio 0.849; 95% CI 0.755-0.954) followed by a period of downward trending of presentations resulting in an absolute drop of 31.5% in twelve months (rate ratio 0.685; 95% CI 0.556-0.843).

CONCLUSIONS

The bundle of capacity-building initiatives instigated by the NN appear to have contributed to a reduction of prisoner presentations.

摘要

背景

囚犯是一个弱势群体，在充满挑战的环境中需要复杂的护理干预，尤其是在提供紧急护理方面。本研究旨在从急诊部门的角度探讨护士导航员（NN）主导的囚犯干预措施的效果。

方法

本研究对一家公立医院急诊部门的囚犯就诊情况进行了回顾性分析。它使用了时间序列分析方法，对公开的匿名数据进行了分析，这些数据是在标准护理评估期间收集的，旨在探讨这种独特的护理模式在 24 个月（12 个预干预和 12 个后干预）内的影响。与 NN 护理模式相关的文件综合提供了关键举措和干预措施的摘要。

结果

引入 NN 后，囚犯每年就诊人数的变化率从+32.8%降至-2.7%。对每 1000 名被监禁囚犯在急诊部门的就诊人数进行中断时间序列分析，证实干预后下降了 15.1%（比率比 0.849；95%CI 0.755-0.954），随后呈现下降趋势，导致在 12 个月内就诊人数绝对减少 31.5%（比率比 0.685；95%CI 0.556-0.843）。