急诊分诊护士准入制度对比及借鉴

急诊分诊护士准人制度是护理专业化发展的趋势之一,目前国内还没有针对急诊分诊护士资质准入制度的相关规定。对急诊分诊护士提出统一的要求,进行统一的岗前培训与考核,取得资质证书后方能上岗,这样可以大大提高急诊预检分诊的质量,降低医疗纠纷的发生。本文介绍了目前国内外急诊分诊护士岗位资质要求、对于分诊护士的培训方式、培训内容及职责范围的差异。     

急诊分诊护士资质准入标准的构建研究

目的构建国内急诊分诊护士资质准入标准,为规范和完善临床急诊分诊护士资质准入及培训提供理论依据。方法采用改良的Delphi专家函询法构建急诊分诊护士资质准入标准,便利选取北京市临床、管理及教育领域30名专家进行函询。结果经两轮函询后,形成专家一致性意见,最终形成一个包含有10个指标条目的急诊分诊护士资质准入标准指标体系。结论探索得出国内急诊分诊护士资质准入标准,为临床分诊护士的资质准入及培训提供理论指导,为今后进一步开展急诊分诊相关研究奠定基础。     

国内急诊预检分诊信息化管理的研究现状

综述了国内急诊预检分诊系统及其信息化管理的现状,指出国内急诊预检分诊系统已初步建立,信息化也有了初步的实践和发展。但分诊标准的不统一、急诊分诊质量控制体系缺乏以及分诊护士素质不齐仍是急诊分诊信息化建立亟待解决的问题。     

粤港两地急诊分诊差异性探讨及借鉴

介绍香港急诊分诊系统,以提高急、危、重症患者的筛选率为主要目标,分诊护士将急诊患者按照病情的轻、重、缓、急进行分类,对病情危重的患者实施最快急救.香港急诊分诊指南操作性强,有具体的量化指标,分诊流程规范化,分诊设施齐全,分诊信息网络化,便于分诊护士全面的收集资料,对患者进行综合病情评估.相对而言,广东省的急诊分诊有待建立统一的分诊标准,优化分诊流程,改善分诊环境,配备完善的分诊设备,加强分诊护士的培训,从而提供更加优质安全的急诊医疗护理服务.     

急诊预检分诊及预警评估工具使用现状的调查研究

目的 调查急诊预检分诊及预警评估工具的使用现状.方法 采用目的抽样法,自行设计问卷,于2019年7月对北京市9所三级甲等医院80名急诊预检分诊护士进行调查.结果 急诊分诊护士中,97.50％认为其首要任务是按病情分诊预检出危重症和潜在危重症,应尽快安排就诊和抢救;93.75％认为在急诊预检分诊时有必要参考预警评估工具;...     

西安市三级医院急诊分诊护士核心能力现状调查及影响因素分析

目的 分析西安市急诊分诊护士核心能力现状，探讨其影响因素，为完善急诊分诊护士培训体系提供参考依据。方法 于2021年1—3月，采取方便抽样选取西安市10所三级医院的240名急诊分诊护士作为研究对象，以问卷星形式发放急诊分诊护士核心能力自评问卷进行现状调查。结果 回收有效问卷236份，有效率为98%,急诊分诊护士核心能力自评问卷总分为(209.33±31.20)分，不同维度条目平均得分由低到高依次为专业发展能力、评判性思维能力、预检分诊能力、管理能力、专业实践能力、沟通协调能力。单因素分析结果表明，不同职称、学历、工作年限、分诊台工作时长的急诊分诊护士核心能力得分差异具有统计学意义(P<0.05)。多元回归分析结果显示，工作年限(P=0.014)与分诊台工作时长(P=0.007)进入回归方程。结论 西安市三级医院急诊分诊护士的核心能力虽处于中等偏上的水平，但专业发展能力稍显薄弱。该职位需合理安排高年资及有一定分诊台工作经验的护士担任，从事预检分诊工作可以有效提升急诊护士的核心能力。     

中法急诊预检分诊制度对比及借鉴

介绍法国急诊预检分诊工作制度:分诊目的明确,即迅速在众多就诊病人中筛查出病情最重者;分诊标准有具体的量化指标,可操作性强;分诊设施齐全,便于护士收集客观、准确的病情信息;分诊护士经过专门培训,有资格准入制度,工作范围明确;分诊信息实施计算机网络管理,方便、快捷.通过对比,我国的急诊分诊亟待建立统一的分诊标准;配备完善的分诊器材;设立专业岗位培训,实施资格准人制度;改进分诊流程,保证病人就诊安全.     

急诊分诊护士准入及培训研究

对国内外分诊护士的入职从学历和职称、工作年限、专科要求、业务能力、职业素养、法律意识、考核和培训等方面进行综述,并阐述了国内外急诊分诊护士培训的现状和要求,提出制定急诊分诊护士入职标准是目前亟须解决的问题。     

急诊患者对分诊标准的认知程度调查

急诊分诊(triage)是急诊护士的重要职能之一.急诊制定相关标准,分诊护士对患者的病情做出简短的临床评价,然后依据患者病情的轻重缓急安排优先诊疗次序,合理分配医疗资源,为公众提供更加优质的急诊医疗服务[1].     

我国急诊分诊工具的研究现状与对策

分析国内急诊分诊工具的现状,找出我国急诊分诊工具存在的问题,针对不同的分诊工具提出不同的应用对策。     

Current status of emergency department triage in mainland China: A narrative review of the literature

In this review, the current status of emergency department triage in mainland China is explored, with the purpose of generating a deeper understanding of the topic. Literature was identified through electronic databases, and was included for review if published between 2002 and 2012, included significant discussion of daily emergency department triage in mainland China, was peer reviewed, and published in English or Chinese. Thematic analysis was used to identify themes which emerged from the reviewed literature. This resulted in 21 articles included for review. Four themes emerged from the review: triage process, triage training, qualification of triage nurses, and quality of triage. The review demonstrates that there is currently not a unified approach to emergency department triage in mainland China. Additionally, there are limitations in triage training for nurses and confusion around the role of triage nurses. This review highlights that emergency department triage in mainland China is still in its infancy and that more research is needed to further develop the role of triage.     

急诊分诊护士培训需求的调查分析

目的:了解目前急诊分诊护士对培训内容及培训方式的需求,制定有针对性的培训计划,提高培训效果。方法:采用问卷调查法,对北京市3家三级甲等医院的122名急诊分诊护士进行调查。结果:所有被调查的护士均认为培训有必要。分诊护士对"急救技能"和"异常心电图识别"知识的需求最强烈,其次为"分诊技巧""临床暴力防御知识",对"护士礼仪知识"和"医院规章制度"相关知识的需求最弱。护士最需要的培训方式依次是"案例分析""理论授课"和"情景模拟"。结论:医院应对分诊护士按需进行分层培训,充分体现优质护理服务,同时提供多渠道、多方位的培训方式,切实提高培训效果和护理质量。     

A study of triage of paediatric patients in Australia

Objectives: To describe the triage of children in a sample of mixed and paediatric emergency departments in Australia in 1999 and to measure the inter‐rater reliability of the National Triage Scale when used by triage nurses for the triage of paediatric patients. Methods: A questionnaire was sent to 11 hospitals, including one paediatric and one mixed emergency department, in each state studied. Triage nurses were asked to assess 25 paediatric patient profiles and to assign appropriate triage categories to each profile. The number of responses within the modal triage category (concurrence), the percentage of responses with a concurrence of at least 50% and the number of responses within one triage category of the modal response (spread) of responses were measured. Triage data for 1999 from the same emergency departments were collected and numbers of children seen and admitted in each triage category were described. The patterns of distribution of triage categories for specific paediatric diagnoses (triage ‘footprints’) were also described. Data from mixed emergency departments were grouped and compared with data from paediatric emergency departments and any differences were described. Results: Seventy‐eight nurses in 10 hospitals responded to the questionnaire. Sixty‐three per cent of all responses had a concurrence of greater than 50%. Ninety‐four per cent of patient profiles were triaged to within one triage category of their modal response. Nurses in paediatric emergency departments (concurrence greater than 50% for 79% of responses) were significantly more consistent in their use of the National Triage Scale compared with nurses in mixed emergency departments (concurrence greater than 50% for 50% of responses). Paediatric emergency department triage nurses were more likely to use the full range of the National Triage Scale and were fourfold as likely to allocate triage categories 4 and 5 to patient profiles. Paediatric hospitals allocated patients to triage categories 4 and 5 for an average of 71% of presentations compared with 47% for mixed emergency departments. Specific diagnoses had characteristic distributions of triage categories, with similar differences seen when comparisons were made between mixed and paediatric emergency departments. Conclusion: Use of the National Triage Scale for the triage of paediatric patients by triage staff is not consistent and there are significant differences between the triage practices of paediatric and mixed emergency departments.     

以病案为基础的教学法结合情景模拟在门诊分诊护士应急能力培训中的应用

目的探讨以病案为基础的教学法(CBS)结合情景模拟在门诊分诊护士应急能力培训中的应用效果。方法 2018年1-4月我院应用CBS结合情景模拟教学法对29名门诊分诊护士进行了应急能力培训,比较培训前后分诊护士应急理论及技能考核成绩、分诊护士自我效能感、焦虑抑郁情绪、门诊分诊工作质量。结果 CBS结合情景模拟教学法进行门诊分诊护士应急能力培训后,门诊分诊护士应急理论、实践技能考核成绩明显高于培训前,培训后GSES评分较培训前明显提高,SAS评分及SDS评分明显低于培训前,差异均有统计学意义(P <0. 05)。结论应用CBS结合情景模拟教学法对门诊分诊护士进行应急能力培训,能明显提高分诊护士的应急能力,提高了分诊护士的自我效能感,改善了分诊护士焦虑抑郁不良情绪,对提高门诊分诊护理工作质量,预防门诊突发事件发生具有重要价值。     

情景模拟与案例分析在急诊分诊护士培训中的应用

目的：探讨急诊分诊护士培训的内容与方法。方法：该院于2008年1月至2009年1月,采用情景模拟与案例分析的培训方法对34名急诊护士进行培训。结果：培训前后,护士的综合专业能力差异有统计学意义（P〈0．01）,分诊护士认为经过培训在分诊技巧、分析解决问题等方面进步显著;急诊医生对护士分诊工作持肯定态度,分诊准确率提高。结论：将情景模拟与案例分析应用于急诊分诊护士的培训中,不仅有利于巩固专科理论知识,提高护士的综合能力,而且利于提高分诊准确率,值得推广。     

"SOAP"分诊法在腹型心肌梗死急诊分诊中的应用与效果

目的 探讨"SOAP"分诊法在腹型心肌梗死急诊分诊中的应用与效果.方法 对护士进行"SOAP"分诊法培训;通过收集患者的主诉资料、观察病情、评估、制订计划实施护理措施的方法进行分诊,比较实施前后的分诊效果.结果 提高了护士分诊准确率、应急处理率、医护判断病情危重一致率及患者的满意度,差异均具有统计学意义(P<0.01或...     

“SOAP”分诊法优化口腔急诊预检分诊管理实践

目的：通过运用“SOAP”分诊法,探讨口腔专科医院急诊科分诊模式与规范。方法：采用“SOAP”分诊法并结合澳大利亚预检系统、美国牙科协会（ADA）和美国口腔颌面外科协会（AAOMS）所定义的口腔急症进行分诊。结果：制定了口腔急诊预检分诊系统。结论：运用“S OA P”分诊法,提高了护士正确判断口腔急症的能力,为抢救赢得了时间,取得了患者和医生的满意,为完善口腔急诊患者服务开辟了一条新的途径,从而促进了口腔急诊护理水平的提高。     

Factors affecting the triage decision-making ability of emergency nurses in Northern China: A multi-center descriptive survey

IntroductionThe quality of triage decision-making is a prerequisite for priority treatment of critically ill patients and effective utilization of medical resources. Figuring out how to improve triage decision-making is still a topic around the global emergency department. Hence, this study aims to promote an understanding of triage priority care and clarify the elements influencing triage decision-making ability, offering reference for the future to improve the quality of triage decision-making.MethodA total of 404 emergency nurses from 11 tertiary hospitals in northern China were surveyed by questionnaire, of which 371 valid questionnaires were submitted (effective rate = 91.83 %). One hospital distributed the questionnaire face-to-face, and the other ten used online form.ResultPrior to occupying triage jobs, only a quarter of participants(25.30 %)were qualified. Less than half of emergency nurses (46.60 %) reported taking part in the triage training program. The emergency nurses' triage decision-making ability score was 166.50 ± 26.90(95 %CI 163.75,169.24) in northern China. Gender(P = 0.003), case discussion(P = 0.024), secondary assessment(P = 0.020)and knowledge of triage consensus(P = 0.027) are independent factors influencing triage decision-making ability.ConclusionEmergency triage practices are less implemented in northern China. The triage decision-making ability of emergency nurses in northern China is at a low level. Providing emergency nurses with diverse opportunities to develop their triage skills, finding effective triage training content, form, and frequency, strengthening implement triage consensus, and wisely managing triage nurse resources would improve triage decision-making.     

Emergency nurses’ knowledge and experience with the triage process in Hunan Province,China

IntroductionTriage is implemented to facilitate timely and appropriate treatment of patients, and is typically conducted by senior nurses. Triage accuracy and consistency across emergency departments remain a problem in mainland China. This study aimed to investigate the current status of triage practice and knowledge among emergency nurses in Changsha, Hunan Province, China.MethodA sample of 300 emergency nurses was selected from 13 tertiary hospitals in Changsha and a total of 193 completed surveys were returned (response rate = 64.3%). Surveys were circulated to head nurses, who then distributed them to nurses who met the selection criteria. Nurses were asked to complete the surveys and return them via dedicated survey return boxes that were placed in discreet locations to ensure anonymity.ResultsJust over half (50.8%) of participants reported receiving dedicated triage training, which was provided by their employer (38.6%), an education organisation (30.7%) or at a conference (26.1%). Approximately half (53.2%) reported using formal triage scales, which were predominantly 4-tier (43%) or 5-tier (34%).ConclusionsThe findings highlight variability in triage practices and training of emergency nurses in Changsha. This has implications for the comparability of triage data and transferability of triage skills across hospitals.