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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Use of a telephone nursing line in a pediatric neurology clinic: one approach to the shortage of subspecialists.
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Use of a telephone nursing line in a pediatric neurology clinic: one approach to the shortage of subspecialists.

机译：在儿科神经内科诊所使用电话护理热线：解决专科医生短缺的一种方法。

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OBJECTIVE: There are not enough pediatric neurologists to meet the many needs of pediatric neurology patients. The Hospital for Sick Children has responded by expanding the nursing role in the pediatric neurology outpatient clinic. The objective of this study was to examine the use of a telephone nursing line in this hospital-based pediatric neurology clinic. METHODS: A cross-sectional study was performed on all telephone call records collected during a 2-week study period. Each initial incoming call concerning a patient was counted as an index call. Associations between clinic type or diagnosis and length of telephone calls were assessed using the chi(2) test. RESULTS: A total of 208 index calls were received, generating a total of 597 incoming and outgoing calls. The most common clinic types were Epilepsy clinic (35.6%) and General Neurology clinic (32.7%), and the most common patient diagnoses were epilepsy (63.5%) and developmental delay (45.2%). Most patients were between the ages of 1 and <7 years (33.9%) and 12 and <18 years (32.8%) and male (55.2%). Most calls were made by mothers (57.2%) to ask about medical administrative issues (28.4%) and/or symptoms (27.9%). Physicians were notified for 47.1% of calls; nurses were twice as likely to notify physicians for calls concerning new symptoms (relative risk: 2.1; 95% confidence interval: 1.6-2.7). Most calls required between 1 and 5 minutes (49.0%). Long telephone calls (>10 minutes) were strongly associated with a diagnosis of epilepsy. CONCLUSIONS: There is a high demand for the neurology nursing line in our clinic. Most telephone calls and most long telephone calls concerned patients with epilepsy. Nurses managed more than half of all telephone calls without physician assistance. Use of a nursing line can aid in the provision of care to complicated subspecialty patients. Additional strategies are needed to optimize delivery of care to high-need medical populations.
机译：目的：没有足够的儿科神经科医生来满足儿科神经病患者的许多需求。病童医院的应对措施是扩大了小儿神经病门诊的护理作用。这项研究的目的是检查在这家以医院为基础的儿科神经内科诊所中使用电话护理热线的方法。方法：在为期2周的研究期内，对收集到的所有电话记录进行了横断面研究。每个与患者有关的初始来电都被计为索引呼叫。使用chi（2）测试评估诊所类型或诊断与电话时长之间的关联。结果：总共收到208个索引调用，生成了597个呼入和呼出电话。最常见的门诊类型是癫痫门诊（35.6％）和普通神经内科门诊（32.7％），最常见的患者诊断是癫痫（63.5％）和发育迟缓（45.2％）。大多数患者的年龄在1到<7岁（33.9％），12到<18岁（32.8％）和男性（55.2％）之间。母亲打来的电话最多（57.2％），询问医疗管理问题（28.4％）和/或症状（27.9％）。通知了医生47.1％的电话;护士通知医生有关新症状的电话的可能性是原来的两倍（相对风险：2.1; 95％置信区间：1.6-2.7）。大多数通话需要1至5分钟（49.0％）之间。长途电话（> 10分钟）与癫痫的诊断密切相关。结论：我们诊所对神经科护理线的需求很高。大多数电话和大多数长电话都与癫痫患者有关。护士在没有医生协助的情况下处理了超过一半的电话。使用护理线可以帮助为复杂的亚专业患者提供护理。需要采取其他策略来优化向高需求医疗人群的医疗服务。

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