An evaluation of nursing practice models in the context of the severe acute respiratory syndrome epidemic in Hong Kong: a preliminary study
An evaluation of nursing practice models in the context of the severe acute respiratory syndrome epidemic in Hong Kong: a preliminary study
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DOI：
10.1111/j.1365-2702.2006.01345.x
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发表时间：
2006-06-01
影响因子：
4.2
通讯作者：
Yang, JCS
中科院分区：
文献类型：
--
作者：
Chan, EA;Chung, JWY;Yang, JCS
目的和目标。香港护士和其他医护人员一样，在SARS爆发期间，专业知识和技能受到严重挑战。目前的护理实践能否支持未来SARS或SARS样患者的护理？如果没有，就需要采取替代做法。本文通过模拟SARS病房，对传统护理模式与不同护理模式进行比较，重点探讨了两种模式的护理效率、感染控制实践和观点。本研究分三个阶段进行。首先，通过四个工作流程观察实现了对护理实践的基线理解。在一天八小时的时间里，四名研究助理观察了内科和发热病房的护理活动。这些数据被用于第二阶段，以构建两套临床小插曲，有关SARS患者护理的传统和替代的实践模式。这些脚本进行了讨论，从研究中的医院不同职级的9名护士，他们的专家验证和输入。在第三阶段，护士参与者和患者演员在模拟环境中制定的小插曲。录像观察和四名护士参与访谈。通过描述性统计和独立t检验分析观察数据。文本数据进行编码和分类的共同意义。传统的做法，从调查结果包括隔间和命名护士护理。虽然前者反映了改良的团队和功能护理，但它并没有像其名称所暗示的那样将病人护理限制在一个小隔间内。后者描绘了一个修改后的初级护理方法在一个团队，与代表团的照顾。感染控制和护士满意度的初步调查结果显示，替代模式比传统的优势。本研究结果为临床试验奠定了基础，临床试验将评估患者护理质量，成本效益和更好的人力资源管理的意义，通过重组目前的护理实践。
Aim and objective. Like other health-care workers, Hong Kong nurses had their professional knowledge and skills seriously challenged during the SARS outbreak. Could current nursing practices support the care of SARS or SARS-like patients in the future? If not, alternative practices would be needed. Providing a preliminary understanding, this paper compares the conventional with different nursing delivery models in a simulated SARS ward and focuses on nurses' efficiency, infection control practices and views of the two models.Design and methods. This study was conducted in three phases. First, a baseline understanding of nursing practices was achieved through four workflow observations. In an eight-hour day, four research assistants observed nursing activities in the medical and fever wards. These data were used in the second phase to construct two sets of clinical vignettes, pertaining to SARS patient care in both conventional and alternative practice models. These scripts were discussed with nine nurses of various ranks from the hospital under study for their expert validation and input. In the third phase, nurse participants and patient actors enacted the vignettes in a simulated setting. Video-taped observations and four nurse participant interviews were employed. Observational data were analysed through descriptive statistics and independent t-tests. Textual data were coded and categorized for common meanings.Results. Conventional practice from the findings consisted of cubicle and named nurse nursing. While the former reflected modified team and functional nursing, it did not confine patient care within a cubicle as suggested by its name. The latter depicted a modified primary nursing approach in a team, with delegation of care. Preliminary findings concerning infection control and nurse satisfaction revealed that the alternative model had an advantage over the conventional.Relevance to clinical practice. This study findings lay the foundation for clinical trials, which would evaluate the significance of patient-care quality, cost-effectiveness and better human resource management by restructuring current nursing practices.