Phillips D L, Steel J E
University of Connecticut School of Nursing, Storrs.
J Prof Nurs. 1994 Mar-Apr;10(2):84-90. doi: 10.1016/8755-7223(94)90068-x.
During the past 20 years, models of autonomous nursing practice, referred to as nursing centers or nurse-managed centers (NMC), have been reported with increasing frequency in the literature. This review of the NMC literature focused on five factors influencing the scope of practice in these settings. Scope of practice was influenced by the purpose of the NMC, whether for faculty practice, community service, or as a setting for specialty nursing practice. A majority of NMCs appear to include nurses in advanced practice, although registered nurses do fulfill a variety of roles. Although the relationship an NMC maintains with the medical community is ideally characterized by collaboration and mutual acceptance, issues of competition arise. NMCs typically target underserved populations or candidates for specialty nursing care such as geriatric or cardiac rehabilitation patients. Finally, the scope of practice defined by an NMC is affected by the center's need to generate income. A survival strategy for NMCs would appear to require (1) provision of high-quality nursing services; (2) public and community support; (3) healthy, collaborative relationships with other health care providers; and (4) documentation of patient outcomes through NMC-based nursing research.
在过去20年里，自主护理实践模式，即护理中心或护士管理中心（NMC），在文献中的报道频率越来越高。本次对NMC文献的综述聚焦于影响这些机构实践范围的五个因素。实践范围受到NMC目的的影响，其目的可能是教师实践、社区服务，或是作为专科护理实践的场所。大多数NMC似乎都有高级实践护士，尽管注册护士也履行着各种职责。虽然NMC与医疗界理想的关系特征是合作与相互认可，但竞争问题也会出现。NMC通常针对服务不足的人群或专科护理的对象，如老年或心脏康复患者。最后，NMC界定的实践范围受该中心创收需求的影响。NMC的生存策略似乎需要：（1）提供高质量护理服务；（2）获得公众和社区支持；（3）与其他医疗服务提供者建立健康的合作关系；（4）通过基于NMC的护理研究记录患者结局。
