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xiaowuheng金虫 (正式写手)
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ENPs IN A&E Emergency nurse practitioners are employed in A&E departments and minor injury units throughout the UK. There are several reasons for this: the need to reduce waiting times and release junior doctors to treat more seriously ill patients, and to compensate for the reduction in junior doctors'working hours. This practice has been encouraged by the Audit Commission as well as guidance on streaming and the 'see and treat' protocols of Reforming Emergency Care. Debate about the lack of standardised ENP training and qualifications is ongoing, and there is continued controversy about the implications of the ENP title in that there is no universally recognised definition of what the role entails. But despite these problems patient satisfaction with the service provided by ENPs I S well documented. The RCN defined an ENP as an experienced registered nurse who has undergone specific additional training, someone who can assess patients with undifferentiated conditions, and diagnose, treat and discharge patients home or to another clinicians. Children with elbow injury and possible supracondylar fracture clearly fit within this role description. They require thorough clinical assessment, appropriate requesting and interpretation of X-rays, accurate diagnosis, and effective management or expedient referral. Emergency nurse practitioners have been shown in randomised controlled trials to be as effective as senior house officers (SHOs) in managing patients with minor injunes. Keltie et al argue that ENPs might in fact provide higher quality care because they are experienced practitioners who have gained much understanding of minor injuries compared to SHOs, who work in A&E for six months and then move on. Byrne et al, in their small study, find that patients are particularly pieased with the standard of communication from nurse practitioners, and receive more health education and first aid advice than those who see doctors. This makes consultations longer so fewer patients are seen but Byrne et al argue that this advice can reduce the rate of reattendance. This theme is expanded by Dolan who holds that quality of care, rather than speed, should be the focus for practitioners. This is worth considering in these target driven days of A&E care. The study by Byrne et al is adult focused, but Keltie eta/ find that ENPs, particularly those with a paediatric background, can improve the quality of children's care also because they are more likely to be skilled in managing paediatric injuries than SHOs. |
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kongxiangshi
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sltmac(金币+1): 谢谢交流，欢迎常来~~ 2011-04-29 00:03:42
xiaowuheng(金币+60, 翻译EPI+1): 2011-04-29 22:39:06
sltmac(金币+1): 谢谢交流，欢迎常来~~ 2011-04-29 00:03:42
xiaowuheng(金币+60, 翻译EPI+1): 2011-04-29 22:39:06