护士主导的初级卫生保健诊所：当代定义、实施促进因素和障碍及其健康影响的范围综述。
Nurse-led clinics in primary health care: A scoping review of contemporary definitions, implementation enablers and barriers and their health impact.
机构信息
School of Nursing and Midwifery, University of Southern Queensland, Ipswich, Queensland, Australia.
Institute of Health and Wellbeing, Federation University Australia, Ballarat, Victoria, Australia.
出版信息
J Clin Nurs. 2024 May;33(5):1724-1738. doi: 10.1111/jocn.17003. Epub 2024 Jan 29.
AIMS
To define nurse-led clinics in primary health care, identify barriers and enablers that influence their successful implementation, and understand what impact they have on patient and population health outcomes.
BACKGROUND
Nurse-led clinics definitions remain inconsistent. There is limited understanding regarding what enablers and barriers impact successful nurse-led clinic implementation and their impact on patient health care.
DESIGN
Scoping review using narrative synthesis.
METHODS
PubMed, MEDLINE, Web of Science, Scopus, CINAHL and PsycINFO were searched to identify nurse-led clinic definitions and models of care between 2000 and 2023. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Narrative synthesis enabled to communicate the phenomena of interest and follows the PRISMA for Scoping Reviews (PRISMA-ScR) checklist.
RESULTS
Among the 36 identified studies, key principles of what constitutes nurse-led clinics were articulated providing a robust definition. Nurse-led clinics are, in most cases, commensurate with standard care, however, they provide more time with patients leading to greater satisfaction. Enablers highlight nurse-led clinic success is achieved through champions, partners, systems, and clear processes, while barriers encompass key risk points and sustainability considerations.
CONCLUSION
The review highlights several fundamental elements are central to nurse-led clinic success and are highly recommended when developing interventional nurse-led strategies. Nurse-led clinics within primary health care seek to address health care through community driven, health professional and policy supported strategies. Overall, a robust and contemporary definition of nurse-led care and the clinics in which they operate is provided.
RELEVANCE TO CLINICAL PRACTICE
The comprehensive definition, clear mediators of success and the health impact of nurse-led clinics provide a clear framework to effectively build greater capacity among nursing services within primary health care. This, in addition, highlights the need for good health care policy to ensure sustainability.
PATIENT OR PUBLIC CONTRIBUTION
No Patient or Public Contribution.
目的
定义初级卫生保健中的护士主导诊所，确定影响其成功实施的障碍和促进因素，并了解其对患者和人群健康结果的影响。
背景
护士主导诊所的定义仍然不一致。对于影响护士主导诊所成功实施的促进因素和障碍，以及它们对患者医疗保健的影响，人们的理解有限。
设计
使用叙述性综合进行范围审查。
方法
在 2000 年至 2023 年间，通过 PubMed、MEDLINE、Web of Science、Scopus、CINAHL 和 PsycINFO 搜索护士主导诊所的定义和护理模式。根据资格标准和方法学质量评估对研究进行筛选和选择。叙述性综合使我们能够传达感兴趣的现象，并遵循 PRISMA 用于范围审查 (PRISMA-ScR) 清单。
结果
在确定的 36 项研究中，确定了构成护士主导诊所的关键原则，提供了一个稳健的定义。在大多数情况下，护士主导诊所与标准护理相当，但它们为患者提供了更多的时间，从而提高了患者的满意度。促进因素强调，通过拥护者、合作伙伴、系统和明确的流程，护士主导诊所的成功得以实现，而障碍则包括关键的风险点和可持续性考虑因素。
结论
该审查强调了几个基本要素是护士主导诊所成功的核心，在制定干预性护士主导策略时强烈推荐这些要素。初级卫生保健中的护士主导诊所旨在通过社区驱动、卫生专业人员和政策支持的策略来解决卫生保健问题。总体而言，提供了护士主导护理及其运作的诊所的全面和现代定义。
临床实践的相关性
全面的定义、明确的成功调解因素以及护士主导诊所对健康的影响为在初级卫生保健中有效增强护理服务能力提供了一个明确的框架。此外，这还强调了需要制定良好的医疗保健政策以确保可持续性。
患者或公众贡献
无患者或公众贡献。
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