背景:急性外科单元(ASU)护理模式是提供急诊手术的新范式转变。在澳大利亚和新西兰引入ASU模型后,已经描述了临床和非临床结果。本文回顾和分析了当前已发表的文献和当代ASU模型的实施方法。
方法:我们进行了全面的数据库搜索,以确定所有与ASU相关的已发表论文。纳入的论文将ASU模型与急诊手术的传统护理模型进行了比较。提取相关临床和非临床终点进行分析。
结果:7篇论文和2篇摘要发表了评估ASU临床和非临床终点的数据。六项研究中有四项报告住院时间减少。三分之二的研究显示急诊科检查的平均时间减少,四分之一的研究报告手术时间减少。此外,5项研究中的4项显示,使用ASU模型的工作时间减少.
结论:临床结局趋势包括住院时间缩短,急诊评估和手术时间,补充非临床结果,包括小时后手术减少和培训机会增加的可能性。已发布的数据存在某些弱点,需要进一步的信息才能了解ASU模型的某些方面对较小中心的适用性。
BACKGROUND: The acute surgical unit (ASU) model of care is a new paradigm shift in the provision of emergency surgery. Clinical and non-clinical outcomes have been described after the introduction of the ASU model in Australia and New Zealand. This paper reviews and analyses the current published literature and methods of implementation of contemporary ASU models.
METHODS: We conducted a comprehensive database search to identify all relevant published papers pertaining to the ASU. Included papers compared ASU models to emergency surgery\'s traditional model of care. Relevant clinical and non-clinical end points were extracted for analysis.
RESULTS: Seven papers and two abstracts published data assessing clinical and non-clinical end points within the ASU. Four out of six studies reported a reduction in hospital length of stay. Two out of three studies showed reduction in mean time to emergency department review and two out of four studies reported a reduction in time to surgery. Additionally, four out of five studies showed a reduction in after hours operating with an ASU model.
CONCLUSIONS: Trends in clinical outcomes are seen including reduced length of stay, time to emergency department assessment and surgery, supplemented by non-clinical outcomes including reduced after hours operating and the potential for increased training opportunities. The published data presents certain weaknesses and further information is required to appreciate the applicability of certain aspects of the ASU model to smaller centres.