The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review
The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review
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DOI：
10.1016/j.ijnurstu.2014.07.006
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发表时间：
2015-01-01
影响因子：
8.1
通讯作者：
Gardner, Glenn
中科院分区：
文献类型：
--
作者：
Jennings, Natasha;Clifford, Stuart;Gardner, Glenn
目的：提供最佳证据，以确定护士服务对成人患者急诊科服务的成本、护理质量、满意度和等待时间的影响。背景：急诊科提供高质量的护理服务正在成为卫生服务中最重要的服务指标之一。急诊科不断增加的服务压力导致了服务创新模式的采用：其中最常见和迅速扩大的是急诊护士服务。在澳大利亚，急诊护士服务的迅速普及已经超过了在与病人护理的安全性和质量相关的结果方面评估这一服务模式的能力。以前的研究现在已经过时，与提供急救护理和执业护士服务的不断变化的领域不相称。数据来源：对2006年至2013年的四个电子数据库进行了全面搜索，以确定评估急诊科执业护士服务影响的研究。使用MEDLINE、CINAHL、EMBASE和Cochrane检索英文文献，包括5年前和7年前完成的两篇系统评价。综述方法：采用三步法。在全面搜索之后，两位评价者对照纳入标准对所有已确定的研究进行了评估。从最初的1013篇研究中，保留了14篇论文，由两名独立的评价者进行方法学质量的批判性评价，并使用标准化工具提取数据。结果：由于没有足够的数据用于荟萃分析，因此采用叙述性综合的方法来总结和报告研究结果。这一系统的回顾表明，急救护士服务对护理质量、患者满意度和等待时间有积极影响。结论：综合现有研究试图为急诊护士服务提供证据基础，以指导医疗领导、政策制定者和临床医生对急诊服务提供改革。研究结果提示，急诊执业护士服务的临床和服务效果的比较措施还需要进一步的高质量研究。在卫生服务需求增加和需要为病人提供及时和有效护理的情况下，这些措施将有助于以证据为基础的卫生服务规划。(C)2014爱思唯尔有限公司。保留所有权利。
Aims: To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients.Background: The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services.Data sources: A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago.Review methods: A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools.Results: Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis.Conclusion: Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reform of emergency service provision. The findings suggest that further high quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in evidence based health service planning. (C) 2014 Elsevier Ltd. All rights reserved.