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开展护士主导的重症监护外联服务,以预先阻止医疗急救团队的呼叫并促进员工学习。

Piloting a Nurse-Led Critical Care Outreach Service to Pre-Empt Medical Emergency Team Calls and Facilitate Staff Learning.

机构信息

Department of Anesthesiology, Zealand University Hospital, Lykkebaekvej 1, 4600 Koege, Denmark.

Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark.

出版信息

Int J Environ Res Public Health. 2023 Feb 27;20(5):4214. doi: 10.3390/ijerph20054214.

Abstract

A nurse-led critical care outreach service (NLCCOS) can support staff education and decision making in the wards, managing at-risk patients with ward nurses to avoid further deterioration. We aimed to investigate the characteristics of patients identified as at-risk, the types of treatments they required to prevent deterioration, the education initiated by the NLCCOS, and the perceived experiences of ward nurses. This prospective observational pilot study using mixed methods took place in one medical and one surgical ward at a university hospital in Denmark. Participants were patients nominated as at-risk by head nurses in each ward, the ward nurses, and nurses from the NLCCOS. In total, 100 patients were reviewed, 51 medical and 49 surgical patients, over a six-month period. Most patients (70%) visited by the NLCCOS had a compromised respiratory status, and ward nurses received teaching and advice regarding interventions. Sixty-one surveys were collected from ward nurses on their learning experience. Over 90% ( = 55) of nurses believed they had learned from, and were more confident with, managing patients following the experience. The main educational areas were respiratory therapy, invasive procedures, medications, and benefits of mobilization. Further research needs to measure the impact of the intervention on patient outcomes and MET call frequency over time in larger samples.

摘要

一个由护士主导的重症监护外展服务(NLCCOS)可以为病房的工作人员提供教育和决策支持,与病房护士一起管理高危患者,以避免病情进一步恶化。我们旨在调查被确定为高危的患者的特征、他们需要预防恶化的治疗类型、NLCCOS 发起的教育以及病房护士的感知经验。这项在丹麦一家大学医院的一个内科和一个外科病房进行的前瞻性观察性试点研究采用了混合方法。参与者包括每个病房的护士长提名的高危患者、病房护士以及 NLCCOS 的护士。在六个月的时间里,共审查了 100 名患者,其中 51 名是内科患者,49 名是外科患者。NLCCOS 访视的大多数患者(70%)呼吸状况受损,病房护士接受了干预措施的教学和建议。从病房护士那里共收集了 61 份关于学习经验的调查问卷。超过 90%(=55)的护士表示,他们在经历后从管理患者中学到了东西,并且更有信心。主要的教育领域是呼吸治疗、有创性操作、药物以及活动的益处。需要进一步的研究来衡量干预措施对患者结局和 MET 呼叫频率的影响,并在更大的样本中随着时间的推移进行测量。

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