• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association >Research in Triage?!?: Using an Integrated, Ethically Driven Framework for Clinical Decision Making
【24h】

Research in Triage?!?: Using an Integrated, Ethically Driven Framework for Clinical Decision Making

机译：分诊研究？！？：使用基于伦理的集成框架进行临床决策

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Your emergency department is having problems at triage. Urgent conditions are going unrecognized, patients with serious illnesses are waiting longer than they should, and patients are being sent to inappropriate areas of your department for care. You know there has to be some way to fix the issues with safe care and safe practice, but the problems seem overwhelmingly complex. What is the best way to identify and fix problems with initial assessment? This article will describe a framework that can be used to identify problems, develop research questions and methods, and propose workable solutions. The framework is an environmental model, which means that all the elements of the model influence all the other elements. At the center are elements or qualities that are particular to an individual nurse (knowledge base, critical application, and moral reasoning) that allow the nurse to obtain and retain knowledge and then apply it appropriately for the good of the patient (Figure). The second ring is composed of intermediate elements (unit leadership and culture, as well as RN-provider communication and relationships) that describe the environment in which the nurse makes decisions. The outermost ring contains elements that are influential, such as the hospital culture,' administrative leadership, and general health care environment. Let's take an initial example of myocardial infarction. Over the course of the winter, you find that many myocardial infarctions are being missed in the initial assessment, and therefore care is delayed. You need to figure out what is going on so you can fix this problem. Looking at the findings from one chart, you find the following: A 65-year-old female patient presents to the emergency department on a Monday with nausea, vomiting, and fatigue. The triage nurse, a float from the medical-surgical floor, decides the most likely cause of the patient's symptoms is a gastrointestinal "bug." The patient waits in the waiting room for several hours, before being brought to a room. The emergency nurse caring for the patient notes that the patient is fatigued and retching, and she starts an intravenous line, performs routine laboratory tests, and hangs a liter of normal saline solution. The physician adds an order for a troponin level to the previously ordered laboratory tests, as well as an electrocardiogram. These new tests are resulted but not verified for several hours. Once the physician sees the results, the patient is admitted to the telemetry floor with acute coronary syndrome.
机译：您的急诊部门在分诊时遇到问题。无法识别紧急情况，患有严重疾病的患者等待的时间比应有的更长，并且患者被送往您部门的不适当区域进行护理。您知道必须采取某种方法通过安全护理和安全实践来解决问题，但是问题似乎极其复杂。用初步评估来识别和解决问题的最佳方法是什么？本文将描述一个可用于识别问题，开发研究问题和方法以及提出可行解决方案的框架。该框架是一个环境模型，这意味着该模型的所有元素都会影响所有其他元素。中心是个别护士特有的要素或素质（知识基础，批判性应用和道德推理），这些要素或素质使护士能够获取和保留知识，然后为患者的利益适当地应用知识（图）。第二个环由中间要素（部门领导和文化，以及RN-提供者的沟通和关系）组成，这些要素描述了护士做出决定的环境。最外层的环包含有影响力的元素，例如医院文化，行政领导和一般医疗环境。让我们以心肌梗塞为例。在整个冬季，您会发现在最初的评估中遗漏了许多心肌梗塞，因此延误了治疗。您需要弄清楚发生了什么，才能解决此问题。查看一张图表中的发现，您将会发现：一名65岁的女性患者在星期一到急诊室就诊，感到恶心，呕吐和疲劳。分诊护士，是从外科手术室浮出的，决定最可能引起患者症状的原因是胃肠道“虫子”。患者被带到房间之前在候诊室等待了几个小时。照顾病人的急诊护士注意到病人疲惫不堪，退缩，她开始静脉输液，进行常规的实验室检查，并挂起一升生理盐水。医师将肌钙蛋白水平的命令添加到先前订购的实验室测试以及心电图中。这些新测试已完成，但几个小时未得到验证。一旦医师看到结果，就将患者送入患有急性冠状动脉综合征的遥测层。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号