急诊分诊护士准入与培训的研究进展

对国内外急诊分诊护士的准入资质、培训现状、培训方法及效果进行综述,提出制定符合我国国情的分诊护士准入制度及培训体系的迫切性,以我国以后急诊分诊的发展有所帮助。     

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。     

我国二级及以上医院急诊分诊依据现状调查

目的调查国内急诊分诊执行情况及分诊依据的现状。方法采用自制调查问卷,对国内113所医院的274名急诊科护士进行急诊分诊执行情况及分诊依据现状的调查。结果目前急诊分诊护士要求不统一,急诊分诊标准存在不足,急诊分诊护士现有培训不能满足临床需要。结论我国在急诊分诊护士培养和急诊分诊标准的建立等方面尚不完善,建立统一规范的分诊标准和专职分诊护士将成为急诊分诊发展的趋势。     

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。     

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.     

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.     

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。     

情景模拟演练对急诊儿科低年资急诊分诊护士岗位胜任能力及分诊质量的影响

目的探讨情景模拟演练对急诊儿科低年资急诊分诊护士岗位胜任能力及分诊质量的影响。方法选择2015年7月至2016年6月急诊儿科低年资护士25名为研究对象,均给予12个不同主题的情景模拟演练培训,比较培训前后护士岗位胜任能力、分诊质量。结果培训后,急诊分诊护士个性特征、护理评价、护患关系、专业能力、胜任能力等评分均明显高于培训前(P <0. 05),理论考试成绩、急诊分诊能力成绩均明显高于培训前(P <0. 05),患儿平均候诊时间明显短于培训前(P <0. 05),分诊准确率、家属满意度明显高于培训前(P <0. 05)。结论情景模拟演练有助于提高急诊儿科低年资急诊分诊护士岗位胜任能力,提高分诊质量,维系良好的护患关系。     

降阶梯思维在急诊分诊护士培训中的应用效果

目的探讨降阶梯思维在急诊分诊护士培训中的应用效果。方法 2012年1-3月,便利抽样法选择南京大学医学院附属鼓楼医院具有5年以上急诊临床工作经验的32名护士,运用降阶梯思维对其进行急诊分诊培训。结果培训后,分诊护士的理论成绩、分诊能力考核成绩较培训前均明显提高,差异有统计学意义(均P0.05);分诊护士对培训的满意度均较高,且培训后,急诊医生对分诊护士的满意度较培训前也明显增高,差异有统计学意义(χ2=5.19,P0.05);培训前、后的分诊准确率分别为96.90%、98.90%,差异有统计学意义(χ2=9.73,P0.01)。结论应用降阶梯思维能够激发分诊护士的学习兴趣,提高分诊护士的理论和分诊水平,有利于保证护理安全。     

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。     

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.     

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。     

情景模拟训练对低年资急诊分诊护士岗位胜任能力及分诊质量的影响

目的探讨情景模拟训练对低年资急诊分诊护士岗位胜任能力及分诊质量的影响。方法采用整群便利抽样法,选取2017年6月至2019年6月本院急诊科低年资护士25名作为研究对象。将情景模拟训练方法引入护士急救培训工作中,比较培训前后护士急救事件岗位胜任能力得分、护士急救技能得分。结果在模拟训练6个月后急诊护士专业知识、专业技术、专业能力及个人综合素质评分均显著高于训练前(P<0.05);CPR、插管配合、洗胃、吸痰、静脉穿刺及电除颤技能评分均显著高于训练前(P<0.05);综合操作时间短于培训前(P<0.05)。结论情景模拟训练应用于低年资急诊分诊护士中,可以显著提高低年资急诊护士的岗位胜任能力和急救技能水平,对提高医院急救成功率及护理水平均具有重要意义。     

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.     

首因效应提高患者对急诊科检诊分诊护士满意率探索

目的：探讨首因效应提高急诊患者对检诊分诊护士满意率的效果。方法：2013-01-2013-02急诊科对分诊检诊护士实施首因效应培训,采用自制调查表和本院分诊护士绩效考核表,对比分析2013-03-2013-05和2012-03-2012-05,急诊分诊检诊护士在实施前后分诊准确率、患者满意率、患者投诉率和绩效考核成绩。结果：实施首因效应实施前后分诊准确率、患者满意率、分诊护士投诉率和分诊护士绩效考核成绩比较,差异有统计学意义（P〈0.05）。结论：首因效应可以显著提高急诊护士分诊准确率、急诊患者对检诊分诊护士的满意率,提高绩效考核成绩,同时降低患者的投诉率。