Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.
Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.
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DOI：
10.1186/s13054-015-0950-5
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发表时间：
2015-05-20
期刊：
影响因子：
--
通讯作者：
van der Hoeven JG
中科院分区：
文献类型：
--
作者：
Douw G;Schoonhoven L;Holwerda T;Huisman-de Waal G;van Zanten AR;van Achterberg T;van der Hoeven JG
护士经常通过直觉而不是通过常规的生命体征测量来识别病人的恶化。在快速反应系统中添加“担心或关注”标志，为护士提供了根据直觉采取行动的机会。确定是什么触发护士担心或担心可能有助于把直觉变成文字，并可能使护士采取行动，他们的直觉感受，并在恶化的早期阶段获得医疗援助。本系统回顾的目的是确定引发护士担心或关注患者病情的体征和症状。我们检索了PubMed、CINAHL、Psychinfo和科克伦图书馆（临床试验）的数据库，使用与“护士”、“担心/关注”和“恶化”这三个概念相关的同义词。我们纳入了关于急性护理医院普通病房成人患者的研究。检索从数据库开始到2014年2月14日进行。检索结果为4，006条记录，18项研究（5项定量，9项定性和4项混合方法设计）被纳入综述。从数据中总共出现了37种反映标准担忧或关注性质的体征和症状，并总结为10个一般指标。结果表明，担心或关注可以存在或不存在生命体征的变化。我们在文献中发现的体征和症状反映了护士担心或关注的性质，护士可能会将这些体征纳入对患者的评估和寻求帮助的决定中。它在生命体征变化之前存在的事实表明，在恶化的早期阶段改善护理的潜力。本文的在线版本（doi：10.1186/s13054-015-0950-5）包含补充材料，可供授权用户使用。
Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the ‘worry or concern’ sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses’ worry or concern about a patient’s condition. We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: ‘nurses’, ‘worry/concern’ and ‘deterioration’. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014. The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs. The signs and symptoms we found in the literature reflect the nature of nurses’ worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration. The online version of this article (doi:10.1186/s13054-015-0950-5) contains supplementary material, which is available to authorized users.
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