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中国误诊学杂志 2010年第29期10卷 7307-7308页

作者：丁红丁东莲解放军309医院急诊科北京100091

目的改变急诊传统排班模式,探讨主责护士分层管理制在急诊护理中的作用。方法解放军309医院急诊科于2008-03始实施主责护士负责制的管理模式,采用相对固定的小组式排班,每组设立一名主责护士进行分层管理。实施主责护士负责制前后,分别... 详细信息

目的改变急诊传统排班模式,探讨主责护士分层管理制在急诊护理中的作用。方法解放军309医院急诊科于2008-03始实施主责护士负责制的管理模式,采用相对固定的小组式排班,每组设立一名主责护士进行分层管理。实施主责护士负责制前后,分别对急诊科25名医生和200名患者进行问卷调查。结果实施主责护士负责制1a后,急诊抢救成功率由91.8%提高至96.2%,患者对护理服务的满意度由91.4%提高至97.1%。结论主责护士负责制的实施,增强了护士综合素质,提高了抢救成功率和服务满意度。

关键词：急症护理/组织和管理

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A case-control study of the transit times through an Accident and Emergency department of ankle injured patients assessed using the Ottawa Ankle Rules

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Accident and Emergency Nursing 2000年第3期8卷 148-154页

作者： Allerston, Julie Justham, David Accident and Emergency Department Lincoln County Hospital Lincoln United Kingdom School of Nursing University of Nottingham Nottingham United Kingdom School of Nursing University of Nottingham C/o Lincoln County Hospital Lincoln LN25 QY Greetwell Road United Kingdom

This paper reports part of a larger study of 354 consecutive attendances to an Accident and Emergency department by patients with ankle injuries. One hundred and ninety-nine patients met the criteria for inclusion in this study. The case study group (n=79) were those patients assessed by a nurse practitioner who had been trained in, and had authority to use of the Ottawa Ankle Rules (OAR) and were referred for radiographs from triage assessment. The control group (initially 120) consisted of those patients who were assessed by nurses who were not trained to be nurse practitioners and were not empowered to use the OAR but were sent for radiographs when assessed at the treatment stage. Sixteen patients were excluded from the study due to missing time data, reducing the control group to 104 patients. Previous studies have suggested that reductions in transit times through the department can be achieved by empowering nurses to request radiographs at the time of initial assessment, although these studies did not look specifically at the application of the OAR. Significant reductions in transit time are demonstrated for those patients who are required to have an X-ray to confirm a diagnosis if this is requested at the time of the triage assessment by nurse practitioners. © 2000 Harcourt Publishers Ltd.

关键词：踝损伤/诊断病例对照研究临床方案/标准急症护理/教育急症护理/组织和管理急诊室医院骨折/诊断职务说明开业护士/教育开业护士/组织和管理护理估计/方法护理估计/标准护理评价研究转诊和会诊/组织和管理时间因素伤病员分拣/方法伤病员分拣/标准青少年成年人老年人老年人 80以上人类中年人

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The Boston Experience

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Accident and Emergency Nursing 2001年第2期9卷 86-91页

作者： Loveridge, B.N. Chesterfield N. Derbyshire Roy. H. Calow Chesterfield S44 5BL United Kingdom

In April 2000, three nurses from Chesterfield (UK) were successful in an application for a travel scholarship. The scholarship was to examine emergency nurse practitioner (ENP) schemes in Boston USA after completion of my dissertation based on the same subject, in the course of which the broad span of ENP work had become obvious to me. Leading up to the trip overseas, we discussed specific objectives we hoped to meet but we did not expect the range of experiences we were exposed to within this busy city. It became apparent while in Boston, that we should avoid becoming too focused otherwise we might miss valuable information or experiences which would benefit practice back in the UK. Six of the most striking issues, which impressed all three of us, are covered in this paper. These are then reflected back to UK practice in an attempt to discover whether these experiences can benefit our own profession. Subjects covered include: student training;ENP training and role parameters;physician assistants;primary care and the effect of information technology on the emergency care culture. © 2001 Harcourt Publishers Ltd.

关键词：波士顿急症护理/教育急症护理/组织和管理急诊室医院/组织和管理大不列颠/人种学国际教育交流开业护士/教育开业护士/组织和管理护士作用组织文化医师助理/教育医师助理/组织和管理初级卫生保健/组织和管理人类

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An update on NHS direct

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Accident and emergency nursing 2000年第3期8卷 160-164页

作者： Royle, J. NHS Direct Bolton United Kingdom

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An A&E nurse's fast-track for potential miscarriage patients

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Accident and Emergency Nursing 2000年第1期8卷 9-12页

作者： Wilson, Wendy Accident and Emergency Department Norfolk and Norwich Hospital Norwich NR1 3SR Brunswick Road United Kingdom

When women present at A&E with vaginal bleeding, it is possible that they are miscarrying, and very likely that they are distressed physically and psychologically. This paper outlines the development and auditing of a fast-track protocol for these women, in response to the author's being unable to help them in the A&E department as quickly as she would have wished. © 2000 Harcourt Publishers Ltd.

关键词：流产自然/诊断流产自然/治疗算法临床方案决策树急症护理/组织和管理急诊室医院护理质量审核时间因素伤病员分拣/组织和管理女(雌)性人类

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ACTRITE: Acute Chest Triage Rapid Intervention Team.

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Accident and emergency nursing 1999年第1期7卷 42-46页

作者： Callaghan, S. Accident and Emergency Department University Hospital Aintree Liverpool United Kingdom

The aim of this paper is to demonstrate how the Acute Chest Triage Rapid Intervention Team (ACTRITE), of North Mersey Community (NHS) Trust, (NMCT) was developed and how it functions. Also demonstrated is a retrospective audit of 50 patients cared for by the team. The ACTRITE Service is a development between NMCT and Aintree Chest Centre. This service integrates primary and secondary care for patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). The ACTRITE team is based in the Accident and Emergency (A&E) Department of Fazakerley Hospital, UK. It is a team of nurses specializing in patients with COPD, supported by senior respiratory physicians. Patients who attend A&E with an exacerbation of their chest condition will be assessed by the team to determine if, with suitable medication, nursing and social support they might safely and preferably be cared for at home. The assessment will consider all aspects of the patient problem and the aim is to care for the patient holistically. If home care is deemed appropriate, ACTRITE will provide full support for the patient at home. This includes regular visits from the ACTRITE nurses, supported in the evening and overnight by the district nursing team.

关键词：社区保健护理/组织和管理急症护理/组织和管理家庭医疗保健服务/组织和管理肺疾病阻塞性/治疗护理评估护理质量审核护理评价研究病人医疗小组/组织和管理伤病员分拣/组织和管理老年人女(雌)性人类男(雄)性

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Lynn Sbaih interviews Chris Moulton, A&E consultant to the Royal Bolton Hospitals NHS Trust, Bolton, UK.

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Accident and emergency nursing 2001年第4期9卷 225-226页

作者： Moulton, C. School of Nursing Midwifery and Health Visiting University of Manchester UK

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References and control of bullying

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Accident and emergency nursing 2001年第1期9卷 2-5页

作者： Dimond, Bridgit University of Glamorgan United Kingdom

Staff Nurse A has been employed in A&E for the past 9 years. Technically she is extremely competent and has achieved a diploma in critical care, ALS, PALS, ATNC and has also trained as a Nurse Practitioner. However, despite her clinical skills, other staff find her difficult to work with. She is moody and bullies more junior nurses and medical students. Some staff nurses find her fun to work with, but strive to keep on her 'right side'. There have been murmerings from medical students, student nurses and new staff nurses over the years about Staff Nurse A picking on them, ostracizing them and generally making life difficult. None of these murmerings has developed into a written complaint. On the occasions when the Senior Nurse has pursued rumours, junior staff have refused to make formal complaints as they say her position in the team is too *** Nurse A has approached Sister R and asked her to write a reference. She shows R another reference written by a fellow Charge Nurse, who has written about A in glowing terms. One of the paragraphs contains the phrase: 'Staff Nurse A is a popular member of the team, who can always be relied upon to support junior colleagues'. What are Sister R's responsibilities pertaining to:a) her fellow Charge Nurse?b) writing a reference?

关键词：攻击急症护理/组织和管理职业间关系责任法律护理监督人类

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Medical assessment units in the West Midlands region: A nursing perspective

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Accident and Emergency Nursing 2000年第4期8卷 196-200页

作者： Wood, Ian Department of Nursing and Midwifery Keele University Keele Staffordshire ST5 5BG 59 The Covert United Kingdom

Within a 'whole system' approach to the management of acute medical referrals, many hospitals have introduced Medical Assessment Units (MAUs) to improve the care of acutely ill patients by assessing their need for hospital admission or discharge. This paper gives details of a research study designed to investigate the extent of MAU provision in the West Midlands Region, how these Units are organized and the nature of nursing roles within them. Results indicate that MAUs are organized and managed in different ways according to the likely length of patient stay. Likewise, nursing roles vary depending upon the context in which the nurses are working. © 2000 Harcourt Publishers Ltd.

关键词：临床工作能力/标准急症护理/组织和管理英格兰医院专科病房/组织和管理职务说明护理估计/组织和管理护理评价研究护理人员医院/教育护理人员医院/组织和管理病人入院方案评价问卷调查公费医疗伤病员分拣/组织和管理人类

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Suturing of minor lacerations by clinical nurse specialists in the emergency department.

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Accident and emergency nursing 1999年第1期7卷 34-38页

作者： Charles, A. Le Vasseur, S.A. Castle, C. Clinical Nursing Faculty of Medicine Monash Medical Centre Monash University Clayton Victoria Australia

A programme enabling clinical nurse specialists (CNS) to suture minor lacerations in the emergency department (ED) was implemented at Monash Medical Centre (MMC), Melbourne, Australia. A descriptive comparative design was used to evaluate the programme. Patients meeting the inclusion criteria of the project were randomly assigned to group 1 (the medical group) and group 2 (the CNS group). Analysis of the data found that patient length of stay was not significantly different between the two groups. However, those patients cared for by the CNS group appeared to be more satisfied with their care and the overall services received. Wound healing outcomes were found to be similar between the CNS sutured group and those sutured by medical staff. The implementation of this new role for CNS in the ED appeared to be successful from the point of view of patient outcomes.

关键词：急症护理/教育急症护理/组织和管理职务说明住院时间/统计学和数值数据临床护理医生/教育临床护理医生/组织和管理护理评价研究病人满意度缝合技术/标准青少年成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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