■新的医疗保健专业人员,如医师助理或助理(PA),扩大了卫生系统满足初级和二级卫生保健环境中人口需求的能力。虽然PA被广泛部署在急诊科(ED),他们在ED中的作用以前没有被正式描述过。本系统的范围界定综述综合并批判性地分析了现有文献中有关在ED中工作的PA的作用的影响和看法。
■我们进行了系统的范围审查。我们搜查了Medline,PubMed,Scopus,PsycINFO,护理和相关健康文献累积指数(CINAHL),ExcerptaMedica数据库(EMBASE)和EMCare进行英语同行评审的研究,描述了PA在ED中的作用。包括定性和定量研究。我们使用QualSyst和混合方法评估工具评估文章的质量。确定了与PA在ED中的作用有关的主题。
■我们共纳入了31项研究。审查中确定的主题包括对PA的看法,等待时间,患者的视力,逗留时间,那些不被看见的人(LWBS),临床结果,预先入院率,福祉和实践范围。在ED中,医生和患者对PA的感知普遍较高。他们不能开处方的障碍是显而易见的。研究表明等待时间减少了,逗留时间,再入院率,当PA在ED工作时,那些没有被看到的人看到中度到低度的患者。有证据表明,PA具有积极的影响,并且在国际ED中对PA的看法很高。有大量证据表明,PA是医疗保健团队的关键成员。他们的工作对低至中度患者特别有帮助。随着医疗保健需求的增加和英国国民健康服务(NHS)的痛苦,这篇综述中综合的证据支持PA可能对NHS产生的潜在积极影响,更具体地说,ED吞吐量指标的改进。
■这篇综述确定了PA在ED中的作用和积极影响。这些发现凸显了ED中PA当前和未来的挑战。
UNASSIGNED: New health care professionals, such as the physician associate or assistant (PA), have expanded the ability of health systems to meet the needs of the population in both primary and secondary health care settings. Although PAs are widely deployed in the emergency department (ED), their role in the ED has not previously been formally described. This systematic scoping
review synthesizes and critically analyzes existing literature on the impact and perception of the role of PAs working in the ED.
UNASSIGNED: We performed a systematic scoping
review. We searched Medline, PubMed, Scopus, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE) and EMCare for English language peer-reviewed studies describing PA roles in the ED. Both qualitative and quantitative studies were included. We assessed the quality of the articles using QualSyst and the mixed methods appraisal tool. Themes regarding PA roles in the ED were identified.
UNASSIGNED: We included a total of 31 studies. Themes identified in the
review included perceptions of the PA, wait times, acuity of patients seen, length of stay, those leaving without being seen (LWBS), clinical outcomes, pre-admission rates, well-being and scope of practice. Both the doctors\' and patients\' perception of PAs in the ED were generally high. The hindrance of them not being able to prescribe was evident. Studies showed a reduction in waiting times, length of stay, readmission rates, and those leaving without being seen when PAs work in the ED seeing moderate- to low-acuity patients. Evidence shows that PAs have a positive impact and the perceptions of the PAs are high in international EDs. There is significant evidence of PAs being key members of the health care team. Their work is particularly helpful for low- to moderate-acuity patients. With the increase in health care demand and a suffering UK National Health Service (NHS), the evidence synthesized in this
review supports the potential positive impact PAs can have on the NHS and more specifically, the improvements of ED throughput metrics.
UNASSIGNED: This
review identified the roles and positive influence of PAs in the ED. These findings highlight current and future challenges for PAs in the ED.