Nurse Anesthetists

护士麻醉师
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  • 文章类型: Observational Study
    目的:比较新招募的护士麻醉医师监测的患者和新招募的麻醉医师监测的患者的麻醉相关结果。
    方法:这是一项回顾性研究。
    方法:我们进行了一项回顾性研究,收集了2017年至2022年间新招募的护士麻醉师和麻醉师的人口统计学信息,并记录了监测后6个月内患者的信息。术后疼痛,紧急躁动,恶心,和呕吐被指定为麻醉相关结局.使用倾向评分匹配来调整协变量。这项研究遵循了STROBE指南。
    结果:该研究的统计分析包括由22名新招募的护士麻醉师监测的4483例患者和由23名新招募的麻醉师监测的4959例患者。与新培训的麻醉师监测的患者相比,由护士麻醉师监测的患者较年轻(42.07±20.00vs.47.39±18.45岁,p<0.001),体重指数较低(23.56±4.46vs.24.19±4.25,p<0.001)。由麻醉师监测的患者女性比例更高(61.62%vs.59.25%,p<0.001),ASAIII和ASAIV的比例很高(17.1%与8.88%,p<0.001),和较长的平均手术持续时间(78.65±59.01vs.70.70±60.65min,p<0.001)。在使用倾向得分匹配来调整协变量后,术后疼痛发生率无统计学差异,紧急躁动,或术后恶心呕吐两组间差异有统计学意义(p<0.05)。
    结论:护士麻醉师在麻醉维持期间单独监测是可行且安全的。两组术后疼痛发生率差异无统计学意义。紧急躁动,或术后恶心呕吐。
    结论:麻醉师的短缺导致麻醉师工作负担重和职业倦怠的高发生率。研究发现,护士麻醉师在主治麻醉师的监督下在手术室单独进行麻醉监测是安全的,确实减轻了麻醉师的工作负担。当前研究的结果有助于在麻醉师短缺的国家扩大护士麻醉师的职业类别。为医院管理者和政策制定者制定医疗护理服务政策提供了新思路。
    OBJECTIVE: To compare anaesthesia-related outcomes between patients monitored by newly recruited nurse anaesthetists and those monitored by newly recruited anaesthesiologists.
    METHODS: This was a retrospective study.
    METHODS: We conducted a retrospective study that collected demographic information on newly recruited nurse anaesthetists and anaesthesiologists between 2017 and 2022 and recorded information on patients within 6 months of monitoring. Postoperative pain, emergency agitation, nausea, and vomiting were designated anaesthesia-related outcomes. Propensity score matching was used to adjust for covariates. The study adhered to the STROBE guidelines.
    RESULTS: The study\'s statistical analysis included 4483 patients monitored by 22 newly recruited nurse anaesthetists and 4959 patients monitored by 23 newly recruited anaesthesiologists. Compared with patients monitored by newly trained anaesthesiologists, the patients monitored by nurse anaesthetists were younger (42.07 ± 20.00 vs. 47.39 ± 18.45 years, p < 0.001) and had a lower body mass index (23.56 ± 4.46 vs. 24.19 ± 4.25, p < 0.001). Patients monitored by anaesthesiologists had a greater proportion of women (61.62% vs. 59.25%, p < 0.001), a high proportion of ASA III and ASA IV (17.1% vs. 8.88%, p < 0.001), and a longer mean surgery duration (78.65 ± 59.01 vs. 70.70 ± 60.65 min, p < 0.001). After propensity score matching was used to adjust for covariates, no statistically significant differences were found in the prevalence of postoperative pain, emergency agitation, or postoperative nausea and vomiting between the two groups (p < 0.05).
    CONCLUSIONS: Nurse anaesthetists monitoring alone during anaesthesia maintenance is feasible and safe. The two groups had no significant differences in the incidence of postoperative pain, emergency agitation, or postoperative nausea and vomiting.
    CONCLUSIONS: The shortage of anaesthesiologists leads to heavy work burden and high incidence of occupational burnout among anaesthesiologists. The study found that it was safe for nurse anaesthetists to perform anaesthetic monitoring alone in the operating room under the supervision of the attending anaesthesiologist and did reduce the burden of anaesthesiologists\' work. The results of the current study contribute to the expansion of occupational categories for nurse anaesthetists in countries where anaesthesiologists are in short supply. It provides new ideas for hospital administrators and policy-makers to formulate medical and nursing service policies.
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  • 文章类型: Journal Article
    背景:阐明医学与护理联合教学(CMN)的有效性很重要,因为在临床实践中,提高患者护理质量和预后至关重要。在这项研究中,我们旨在确定CMN在护士麻醉师培训中的疗效。
    方法:该研究包括为期6个月的培训课程和前后对照研究。总的来说,招募了59名护士。前30名护士纳入常规单一教学护理(SN)组,仅参加护理相关课程。接下来的29名学生被纳入CMN组,并接受了一般医学和护理特定课程。训练前后,比较两组医护协作能力得分和知识得分。在研究结束时,对教学满意度和临床推理技能提高的定性意见进行了查询,并进行了内容分析。
    结果:CMN组的参与者在医学和护理协作能力以及知识测试中的表现优于SN组的参与者。CMN组在教学满意度评价方面优于SN组,特别是在麻醉师专业的学习方面,改善临床实践,培养动机,并影响人们如何看待工作中的挑战。此外,CMN组的参与者认为他们的临床推理能力得到了提高.
    结论:与SN组相比,CMN组的患者护理结果得到了改善,医疗和护理合作,和临床推理技能。
    BACKGROUND: Clarifying the effectiveness of co-teaching in medicine and nursing (CMN) is important as it is crucial in clinical practice to improve the quality of patient care and prognosis. In this study, we aimed to determine the efficacy of CMN in nurse anesthetist training.
    METHODS: The study comprised a 6-month training session and a before-and-after controlled study. In total, 59 nurses were recruited. The first 30 nurses were enrolled in the conventional single-teaching in nursing (SN) group and only took nursing-related courses. The next 29 students were enrolled in the CMN group and received both general medical and nursing-specific curricula. Before and after training, medical and nursing collaboration competency scores and knowledge scores were compared between the two groups. At the end of the study, qualitative comments on teaching satisfaction and clinical reasoning skills improvement were queried, and content analysis was performed.
    RESULTS: Participants in the CMN group outperformed those in the SN group in tests of medical and nursing collaboration abilities as well as knowledge. The CMN group outperformed the SN group in terms of teaching satisfaction evaluation, particularly in terms of fostering learning in the anesthetist specialty, improving clinical practice, fostering motivation, and influencing how people think about challenges at work. Furthermore, participants in the CMN group felt that their clinical reasoning abilities had improved.
    CONCLUSIONS: In comparison to the SN group, the CMN group had enhanced outcomes of patient care, medical and nursing collaboration, and clinical reasoning skills.
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  • 文章类型: English Abstract
    BACKGROUND: The introduction and development of the advanced practice registered nurse (APRN) is a global trend in nursing. However, the development of APRNs in Taiwan remains uncertain and lacks necessary consensus.
    OBJECTIVE: This research study aimed to explore the views and suggestions of nursing experts in industry, government, and academia regarding the development of APRNs (clinical nurse specialists, case managers, certified clinical registered nurse anesthetists, and certified nurse-midwives) in Taiwan.
    METHODS: Data were collected from March to August 2017. Sixty-four experts participated in one of six focus group discussions held in northern, central, and southern Taiwan. These group discussions were recorded and transcribed verbatim with the consent of the participants. Content analysis was used to analyze the transcribed data.
    RESULTS: The comments and suggestions raised during the discussions were categorized into four major themes: professional development of necessity, core competencies, accreditation, and future promotion-related issues. Each theme was further divided into several subthemes.
    CONCLUSIONS: The opinions of relevant experts regarding the current status of development of the roles, practical scope, and management and suggestions for APRNs were summarized to facilitate the future development of APRNs in Taiwan in terms of education, core competencies, certification, and practical scope. Furthermore, the results may be referenced in the establishment of a nursing consensus model and as a basis for promoting APRNs.
    BACKGROUND: 蛻變的白衣天使—進階護理師的發展與突破.
    UNASSIGNED: 發展進階護理師制度為全球趨勢,然而台灣進階護理制度的發展仍處於妾身未明階段,亟需凝聚護理界共識。.
    UNASSIGNED: 本研究旨在探討產官學界護理專家對台灣發展進階護理師(臨床護理專家、個案管理師、註冊麻醉護理師、註冊助產護理師)的看法與建言。.
    UNASSIGNED: 資料收集時間為2017年3月至8月。總計64位專家分別參與北、中、南6場的焦點團體討論,所有內容皆經研究對象同意錄音與繕打成逐字稿後轉製成文本,並以內容分析法進行資料分析。.
    UNASSIGNED: 產官學界之護理專家對台灣發展進階護理師的意見與建議可歸納為四項主題:發展需求、核心能力、認證與未來推動相關議題,每一主題皆區分出數個次主題。.
    UNASSIGNED: 本研究結果彙整護理產官學專家對台灣發展各類進階護理角色功能、執業範疇與管理之現況意見,以及對台灣未來發展各類進階護理角色在教育、核心能力、證照與執業範疇等之建議,可作為建立護理共識模式的視窗及未來推動進階護理師制度的依據。.
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  • 文章类型: Journal Article
    背景:在中国,麻醉护士的职责和权限没有统一的标准,导致麻醉医生和护理经理的不同专业期望,这可能导致护士麻醉师的高水平角色压力和倦怠。高职业风险和繁重的工作等其他因素也可能导致角色压力和职业倦怠。
    方法:在这项多中心横断面研究中,对山东省6所三级医院的198名护士进行了在线问卷调查。t检验,方差分析,线性回归,并采用logistic回归分析角色压力和职业倦怠的危险因素。
    结果:角色压力中的角色冲突和角色歧义得分分别为30.61±9.53和31.89±9.56;对收入和工作环境的满意度,医院的注意,多年的护士经验,关于护士麻醉师的职业范围的清晰度,对职业前景的态度是角色压力的独立危险因素。倦怠数据是非正态分布的,以中位数和四分位数表示。情绪疲惫的分数,去个性化,职业倦怠中的个人成就为30(26-34),11(8-14)和23(20-26)。每周工作小时数,对职业前景的态度,对工作环境和收入的满意度,身体健康,性别,教育程度是职业倦怠的独立危险因素。
    结论:中国麻醉护士被发现有高角色压力和职业倦怠的危险,需要管理者注意的情况。
    BACKGROUND: In China, there is no unified standard for the responsibilities and authority of nurse anesthetists, resulting in different professional expectations from anesthesiologists and nursing managers, which may result in high levels of role stress and burnout in nurse anesthetists. Additional factors such as high occupational risk and heavy work may also contribute to role stress and burnout.
    METHODS: In this multicenter cross-sectional study, an online questionnaire survey was conducted among 198 nurses from six tertiary hospitals in Shandong Province. The t test, analysis of variance, linear regression, and logistic regression were used to analyze the risk factors for role stress and professional burnout.
    RESULTS: The scores of role conflict and role ambiguity in role stress were 30.61 ± 9.53 and 31.89 ± 9.56, respectively; satisfaction with income and the working environment, the hospital\'s attention, years of experience as a nurse, clarity concerning the nurse anesthetist\'s occupational scope, and attitude to career prospects were independent risk factors for role stress. The burnout data were non-normally distributed and were expressed as medians and quartiles. The scores of emotional exhaustion, depersonalization, and personal achievement in professional burnout were 30 (26-34), 11 (8-14), and 23 (20-26) respectively. The number of working hours per week, attitude to career prospects, satisfaction with the working environment and income, physical health, gender, and education were independent risk factors for burnout.
    CONCLUSIONS: Chinese nurse anesthetists were found to be in danger of high role stress and professional burnout, a situation requiring the attention of managers.
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  • 文章类型: Journal Article
    背景:越来越多的国家利用护士麻醉师作为麻醉护理提供者来弥补麻醉师的不足。
    目的:研究将执业范围扩大的麻醉护士引入麻醉护理是否会危害患者安全和麻醉护理质量。
    方法:这项观察性研究使用了中断的时间序列设计。
    方法:位于中国西南地区的一所大都会教学肿瘤医院。
    方法:纳入2015年1月至2017年12月在全身麻醉下进行外科手术的24290例患者。
    方法:2016年5月,向执业范围扩大的麻醉护士介绍麻醉护理。获取行政和医疗记录数据以确定麻醉结果的发生,包括气管插管失败和无法使用面罩通气。抽吸,麻醉后护理室的气道问题,体温过低(温度≤35°C或寒冷),意外在麻醉后护理室停留超过3小时,意外的重症监护室入院,再插管,血管和心肺疾病和死亡。进行统计过程控制分析以测试随时间变化的结果的特殊原因变化。
    结果:研究结果表明,在麻醉后护理室中停留超过3小时的患者比例显着下降,并且在麻醉护士引入麻醉护理后体温过低。其他麻醉结果无明显变化。
    结论:结果表明,麻醉护士参与麻醉护理的范围扩大并不会危及患者的安全或麻醉质量。此外,它可能对防止在麻醉后护理室中长时间停留和体温过低产生有益影响。需要进一步的研究来检查护士麻醉师在所有临床环境中参与麻醉护理的影响。
    BACKGROUND: More and more countries utilize nurse anesthetists as an anesthetic care provider to make up for the insufficiency of anesthesiologists.
    OBJECTIVE: To examine whether introducing nurse anesthetists with expanded scope of practice to anesthetic care would jeopardize the safety of patients and quality of anesthetic care.
    METHODS: This observational study used an interrupted time series design.
    METHODS: A metropolitan teaching cancer hospital located in Southwest China.
    METHODS: 24290 patients with surgical procedures under general anesthesia from January 2015 to December 2017 were included.
    METHODS: In May 2016, nurse anesthetists with expanded scope of practice were introduced to anesthetic care. Administrative and medical record data were accessed to identify the occurrence of anesthetic outcomes including failed tracheal intubation and inability to ventilate with mask, aspiration, problem with airway in the post-anesthesia care room, hypothermia (temperature ≤ 35°C or chills), unplanned stay in the post-anesthesia care room longer than 3 hours, unexpected intensive care unit admission, reintubation, vascular and cardiopulmonary disorders and death. Statistical process control analysis was conducted to test special cause variation in outcomes over time.
    RESULTS: Findings demonstrated significant decrease in the proportion of patients staying in the post-anesthesia care room longer than 3 hours and with hypothermia following nurse anesthetists introduced to anesthetic care. Other anesthetic outcomes were not significantly changed.
    CONCLUSIONS: The results demonstrate that involvement of nurse anesthetists with expanded scope of practice in anesthetic care did not jeopardize patients\' safety or quality of anesthesia. Moreover, it may have beneficial impact in preventing prolonged stay in the post-anesthesia care room and hypothermia. Further research is required to examine the impact of involvement of nurse anesthetists in anesthetic care across all clinical contexts.
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  • 文章类型: Journal Article
    目的:江苏省首家麻醉护士培训中心,中国成立了。这项研究的目的是了解基于国际护士麻醉医师联合会(IFNA)标准的中国护士麻醉医师培训计划的现状和有效性。
    背景:中国最近发布了明确的政策,以提高麻醉护理质量并确保患者的安全和舒适。因此,护士麻醉师的角色受到了更多的关注,强调制定和实施相关培训的重要性。
    背景:IFNA标准被应用于护士麻醉师专业培训计划的制定,这有望为各种医疗机构提供参考,并导致护理质量和效率的提高和统一。
    方法:这些标准分为两个指标:课程和核心能力。通过问卷调查,课程评估,以及实施培训计划前后的满意度调查,对培训方案的有效性进行了分析。
    结果:该计划完成后的理论评估比以前更高,护士麻醉师的核心能力得到了显着改善。总的来说,课程非常令人满意和重要。
    结论:课程设计基于IFNA标准。受过系统培训的护士麻醉师可以与其他专业人员更好地提供麻醉护理。目的是改善麻醉护理,减少错误,提高医生满意度,让麻醉护士认识到自己的价值。总的来说,实施IFNA标准培训后,麻醉护理质量有所提高。
    OBJECTIVE: The first training center for nurse anesthetists in Jiangsu Province, China was established. The aim of this study is to understand the status of and effectiveness of a training program based on International Federation of Nurse Anesthetists (IFNA) standards for nurse anesthetists in China.
    BACKGROUND: China recently issued a clear policy to improve the quality of anesthesia care and to ensure the safety and comfort of patients. As a result, the roles of nurse anesthetists have received more attention, highlighting the importance of the development and implementation of relevant training.
    BACKGROUND: IFNA standards were applied to the development of a specialized training program for nurse anesthetists, which is expected to serve as a reference for various medical institutions and to lead to increased uniformity and improvement in the quality and efficiency of care.
    METHODS: These standards are divided into two indicators: curriculum and core competencies. Through questionnaires, course evaluations, and satisfaction surveys before and after the implementation of the training program, the effectiveness of the training program was analyzed.
    RESULTS: Theoretical assessment of the program was higher after its completion than before and the core competencies of nurse anesthetists significantly improved. Overall, the curriculum was highly satisfactory and important.
    CONCLUSIONS: Curriculum design was based on IFNA standards. Nurse anesthetists who are trained in a systematic way can work better with other professionals in providing anesthesia care. The objectives are to improve anesthesia care, reduce errors, improve physician satisfaction, and allow nurse anesthetists to realize their value. Overall, quality of anesthesia care improved after implementation of IFNA-standard training.
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  • 文章类型: Journal Article
    As the backbone for the treatment of patients with coronavirus disease 2019 (COVID-19), nurses have been playing key roles in cabin hospitals, isolation wards, and intensive care units for critical cases. Anesthesia nurses have their own professional specialties, such as airway management, the use and maintenance of life support equipment, including ventilators, and the use of high-flow oxygen equipment. With rich experience in emergency responses and nursing, anesthesia nurses, along with emergency nurses and critical care nurses, play important roles during the treatment of patients with COVID-19. In our hospital, 27 of 34 anesthesia nurses participated in the front-line fight against COVID-19 and did an excellent job. Anesthesia care by nurses is relatively new in China, and the role of anesthesia nurses during a disaster response has not been fully appreciated. Given their specialty, anesthesia nurses have played important roles in the treatment of patients with COVID-19. We hope that authorities will consider including anesthesia nurses in national disaster response medical rescue teams.
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