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院前急救护士专科在救护车上照顾非特异性主诉患者的经验 - 一项定性访谈研究。

Pre-hospital emergency nurse specialist's experiences in caring for patients with non-specific chief complaints in the ambulance - A qualitative interview study.

机构信息

Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Academic Emergency Medical Service, Region Stockholm, Stockholm, Sweden.

Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.

出版信息

Int Emerg Nurs. 2022 Jul;63:101178. doi: 10.1016/j.ienj.2022.101178. Epub 2022 Jun 20.

DOI:10.1016/j.ienj.2022.101178
PMID:35738055
Abstract

BACKGROUND

Pre-hospital emergency nurse (PEN) specialists are faced with patients presenting with non-specific chief complaints (NSC) to the emergency medical service (EMS) on a daily basis. These patients are often elderly and one in three has a serious condition and their acuity is not recognized.

OBJECTIVE

The aim of the current study was to explore PEN specialists' experiences in caring for patients presenting with non-specific chief complaints.

DESIGN

A qualitative study design with eleven individual interviews of PENs, between 2018 and 2020. Qualitative content analysis was used.

RESULTS

The analyses generated three categories including subcategories. The categories were "Unexplained suffering". "Systematic approach and experience enhances medical safety". "Organizational processes can be optimized". The relation between the categories compiled as ́In-depth systematic assessment is perceived to reduce suffering and increases patient safetý.

CONCLUSION

The PENs experiences in caring for patients presenting with non-specific chief complaints show that an in-depth systematic assessment may lead to a meaningful caring encounter which enables the identification of the cause of the chief complaint. Experience and a systematic approach were considered as essential to enhance medical safety. This could be strengthened through feedback on the nurse's care provided by care managers and employers. To optimize organizational processes, the development of the opportunity to convey the patient to different levels of care can be an important component.

摘要

背景

每天都有非特定主诉(NSC)的患者到急诊医疗服务(EMS)就诊,这使得院前急救护士(PEN)专家面临着挑战。这些患者通常年龄较大,每三个患者中就有一个病情严重,但他们的病情严重性没有得到识别。

目的

本研究旨在探讨 PEN 专家在护理非特定主诉患者方面的经验。

设计

这是一项 2018 年至 2020 年间对 11 名 PEN 进行的个人访谈的定性研究设计。采用定性内容分析法。

结果

分析产生了三个类别,包括子类别。这些类别是“无法解释的痛苦”、“系统方法和经验增强医疗安全性”、“组织流程可以优化”。类别之间的关系可以概括为“深入的系统评估被认为可以减轻痛苦并提高患者安全性”。

结论

PEN 在护理非特定主诉患者方面的经验表明,深入的系统评估可能会带来有意义的护理接触,从而识别主诉的原因。经验和系统方法被认为是增强医疗安全性的关键。通过护理经理和雇主对护士护理的反馈,可以加强这一点。为了优化组织流程,为不同层次的护理传递患者的机会可以成为一个重要组成部分。

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