An overview of systematic reviews on the collaboration between physicians and nurses and the impact on patient outcomes: what can we learn in primary care?
An overview of systematic reviews on the collaboration between physicians and nurses and the impact on patient outcomes: what can we learn in primary care?
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DOI：
10.1186/s12875-017-0698-x
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发表时间：
2017-12-22
影响因子：
2.9
通讯作者：
Van Bogaert P
中科院分区：
文献类型：
--
作者：
Matthys E;Remmen R;Van Bogaert P
需要加强初级保健，以应对许多社会挑战。初级保健的集体实践促进了与其他卫生保健提供者的合作，这鼓励了护理协调，并提高了初级保健的质量。随着时间的推移，护士的角色和责任不断扩大，与医生相比，护士经常提供相同的高质量慢性病患者护理，即使患者满意度更高。初级保健医生和护士之间的专业合作是一个可能的战略，以实现在加强初级保健系统所需的质量成果。本研究的目的是综合文献中的证据，医生和护士之间的合作对患者的结果在初级保健或类似的护理环境的影响。在4个数据库中对同行评议进行了系统综述：科克伦、MEDLINE、EMBASE和CINAHL。从1970年至2016年5月22日的所有研究均纳入检索策略中。分别对标题、摘要和全文进行了综述。三位作者中至少有两位独立审查了检索中检索到的277篇摘要和58篇全文，以确定包含所有入选标准的摘要和全文。两位作者使用AMSTAR质量评估工具独立评估了综述的方法学质量。共有11篇系统性综述符合所有纳入标准，描述了近50种不同的患者结局。在大多数评论中，得出的结论是护士确实有附加值。血压、患者满意度和住院治疗是患者结局，其中三项或更多系统评价得出结论，与常规护理相比，医生和护士合作时结果更好。结直肠筛查、住院时间和健康相关的生活质量是合作似乎无效的结果。医生和护士之间的合作可能会对一些病人的结果和各种病理产生积极的影响。为了应对初级保健的未来挑战，有必要与受过充分教育的护士进行更全面的跨专业合作护理模式。本文的在线版本（10.1186/s12875-017-0698-x）包含补充材料，可供授权用户使用。
Primary care needs to be strengthened in order to address the many societal challenges. Group practices in primary care foster collaboration with other health care providers, which encourages care co-ordination and leads to a higher quality of primary care. Nursing roles and responsibilities expanded over time and nurses have been found to often provide equal high-quality chronic patient care compared to physicians, even with higher patient satisfaction. Inter-professional collaboration between primary care physicians and nurses is a possible strategy to achieve the desired quality outcomes in a strengthened primary care system. The objective of this research is to synthesize the evidence presented in literature on the impact of collaboration between physicians and nurses on patient outcomes in primary care or in comparable care settings. A systematic review of peer-reviewed reviews was performed in four databases: COCHRANE, MEDLINE, EMBASE and CINAHL. All studies from 1970 until May 22 2016 were included in the search strategy. Titles, abstracts and full texts were respectively reviewed. At least two of the three authors independently reviewed each of the 277 abstracts and 58 full texts retrieved in the searches to identify those which contained all the inclusion criteria. Two authors independently appraised the methodological quality of the reviews, using the AMSTAR quality appraisal tool. A total of eleven systematic reviews met all the inclusion criteria and almost fifty different patient outcomes were described. In most reviews, it was concluded that nurses do have added value. Blood pressure, patient satisfaction and hospitalization are patient outcomes where three or more systematic reviews concluded better results when physicians and nurses collaborated, compared to usual care. Colorectal screening, hospital length of stay and health-related quality of life are outcomes where collaboration appeared not to be effective. Collaboration between physicians and nurses may have a positive impact on a number of patient outcomes and on a variety of pathologies. To address future challenges of primary care, there is a need for more integrated inter-professional collaboration care models with sufficiently educated nurses. The online version of this article (10.1186/s12875-017-0698-x) contains supplementary material, which is available to authorized users.
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影响因子：
2
作者：
Schmalenberg, C;Kramer, M;Rapp, D
通讯作者：
Rapp, D
影响因子：
4
作者：
Pollock M;Fernandes RM;Hartling L
通讯作者：
Hartling L
影响因子：
2.7
作者：
Rosenstein, AH;O'Daniel, M
通讯作者：
O'Daniel, M
影响因子：
3.7
作者：
Dwan K;Gamble C;Williamson PR;Kirkham JJ;Reporting Bias Group
通讯作者：
Reporting Bias Group
影响因子：
2.8
作者：
Longman, Jo M.;Passey, Megan E.;Morgan, Geoffrey G.
通讯作者：
Morgan, Geoffrey G.