Cruikshank B M, Clow T J, Seals B
Med Care. 1986 Apr;24(4):340-9. doi: 10.1097/00005650-198604000-00005.
Previous research has neglected to delineate pediatric nurse practitioner (PNP) roles in tertiary care settings (TCS). New PNP roles have developed as TCS seek cost-effective solutions to providing quality patient care and to meeting new demands for outpatient care. The authors evaluated the roles of 11 PNPs in eight specialty clinics in a large university TCS. Data were collected from various sources, including interviews, typical day information, and on-site information. Content analysis was used to analyze aspects of the PNP role that are different from other PNP clinic settings that potentially contribute to greater continuity of patient care. TCS PNPs spent less time in direct patient care and more time providing care by telephone, teaching health professionals, consulting, comforting, and counseling. PNPs performed more in-depth counseling (situational crises) and administrative tasks (follow-up, record review) and fewer primary care tasks (physical examinations) than expected. The type of clinic, average patient age, case load, and physician availability modified the PNP role. It was concluded that PNPs have a viable TCS role and contribute to patient care by performing a wide range of functions vital to a multispecialty setting.
以往的研究忽视了儿科执业护士（PNP）在三级医疗环境（TCS）中的角色。随着三级医疗环境寻求具有成本效益的解决方案来提供优质的患者护理并满足门诊护理的新需求，新的儿科执业护士角色应运而生。作者评估了一所大型大学三级医疗环境中8个专科诊所里11名儿科执业护士的角色。数据从各种来源收集，包括访谈、日常工作信息和现场信息。内容分析用于分析儿科执业护士角色中与其他儿科执业护士诊所环境不同的方面，这些方面可能有助于提高患者护理的连续性。三级医疗环境中的儿科执业护士在直接患者护理上花费的时间较少，而通过电话提供护理、教导卫生专业人员、进行咨询、安慰和辅导的时间较多。与预期相比，儿科执业护士进行了更多深入的辅导（情况危机）和行政任务（随访、记录审查），而初级护理任务（体格检查）较少。诊所类型、患者平均年龄、工作量和医生可及性改变了儿科执业护士的角色。研究得出结论，儿科执业护士在三级医疗环境中具有可行的角色，并通过执行对多专科环境至关重要的广泛职能为患者护理做出贡献。
