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Abstract

Scopo: Descrivere quanto si scrive in letteratura in merito agli accessi non urgenti nei Dipartimenti di Emergenza e evidenziare i ruoli infermieristici associati, nel periodo 2003 - 2013. Metodo: E' stata effettuata una revisione della letteratura internazionale utilizzando la banca dati PubMed. Sono stati utilizzati 41 articoli significativi. Risultati: Gli articoli analizzati riguardano: l'organizzazione dei D.E., i modelli di risposta (Fast Track-See and Treat etc.) in alcuni Paesi e la valutazione dei ruoli e delle competenze infermieristiche. In letteratura, il modello e i ruoli studiati si sono rivelati efficaci nel ridurre i tempi di attesa nei D.E. e nell'aumentare la soddisfazione degli utenti senza ridurre la qualití  dell'outcome delle cure erogate. Conclusioni: In letteratura emerge che l'attuazione del sistema Fast Track non può esulare dall'impiego di personale infermieristico con competenze avanzate nell'ambito dell'emergenza. L'introduzione di queste figure presuppone che i sistemi sanitari debbano affrontare il problema del lavoro interprofessionale.

Parole Chiave: Fast Track, infermieristica di emergenza, pronto soccorso, traumi minori, affollamento, accessi non urgenti, See and Treat

Non-urgent accesses and nurses' roles in Emergency Department: a narrative literature review

Purpose: To detect what is written in literature with respect to the access of non-urgent patients in Emergency Department, highlighting associated nursing roles during the period 2003-2013. Method: A literature review on international literature was carried out using PubMed database, where 41 significant articles were selected. Results: The articles analyzed are focused on the organization of the E.D., the response patterns (Fast Track-See and Treat etc.) in some countries and the evaluation of the nursing roles and competences. In literature, the model and the roles studied have proved to be effective in reducing waiting times in E.D. and increasing users' satisfaction without reducing the quality of provided care. Conclusions: The literature shows that the implementation of Fast Track must be developed with a nursing staff with advanced skills on emergency. The introduction of these roles assumes that health systems should address the problem of inter-professional work.

Keywords: Fast Track, Emergency Nursing, Advanced Nurse Practitioner Nurse Practitioner, Crowding, Emergency Department, Minor Injuries, Non urgent Emergency access, See and Treat

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Bornaccioni, C., Coltella, A., Pompi, E., & Sansoni, J. (2014). Accessi non urgenti nel Dipartimento di Emergenza (D.E.) e ruoli dell’infermiere. Una revisione narrativa della letteratura. PROFESSIONI INFERMIERISTICHE, 67(3). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/115
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Riferimenti

  • Agenzia Nazionale per i Servizi Sanitari Regionali AGENAS (2013). Assisitenza H24 e riduzione degli accessi improprio in Pronto Soccorso: evidenze e indirizzi. Quaderni di Monitor 11, 34:38.
  • Aiken L.H., Sloane D.M., Bruyneel L., van Den Heede K., Griffiths P., Busse R., Diomidous M., Kinnunen J., Kozka M., Lesaffre E., Mc Hugh M.D., Casbas M.T.M., Rafferty A.M., Schwendimann R., Scott A., Tishelman C., van Achterberg T., Sermeus W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet. doi: 10.1016/S0140-6736(13)62631-8.
  • Bambi S., Giusti M. & Becattini G. (2008). See&Treat emergency department: the shift from doctors to nurses with advanced skills. A literature review. Assist Inferm Ric, 27(3), 136-144.
  • Bazian Ldt (2005). Do nurse practitioner provide equivalent care to doctors as first point of care contact for patients with undifferentiated medical problems? Evidence-Based Healthcare & Public Health, 9, 179-91.
  • Brysiewicz P. & Bruce J. (2008). Emergency nursing in South Africa. Int Emerg Nurs, 16(2), 127-131. doi: 10.1016/j.ienj.2008.01.001
  • Carter A. J. & Chochinov A. H. (2007). A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department. Cjem, 9(4), 286-295.
  • Combs S., Chapman R. & Bushby A. (2006). Fast Track: one hospital's journey. Accid Emerg Nurs, 14(4), 197-203. doi: 10.1016/j.aaen.2006.07.004
  • Combs S., Chapman R. & Bushby A. (2007). Evaluation of Fast Track. Accid Emerg Nurs, 15(1), 40-47. doi: 10.1016/j.aaen.2006.07.006
  • Commissione sanití del Senato (2011) Nuovo schema di documento conclusivo presentato dal relatore sull'indagine conoscitiva sul trasporto degli infermi e sulle reti di emergenza ed urgenza
  • Conlon C., O'Connor C., Mc Brearty P. & Carpenter B. (2009). Minor injury attendance times to the ED. Int Emerg Nurs, 17(3), 169-172. doi: 10.1016/j.ienj.2008.12.006
  • Considine J., Kropman M. & Stergiou H. E. (2010). Effect of clinician designation on emergency department Fast Track performance. Emerg Med J, 27(11), 838-842. doi: 10.1136/emj.2009.083113
  • Considine J., Lucas E., Payne R., Kropman M., Stergiou H. E. &Chiu, H. (2012). Analysis of three advanced practiceroles in emergency nursing. Australas Emerg Nurs J, 15(4), 219-228. doi: 10.1016/j.aenj.2012.10.001
  • Considine J., Martin R., Smit D., Jenkins J. &Winter C. (2006). Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department. Int J Nurs Pract, 12(4), 205-213. doi: 10.1111/j.1440-172X.2006.00570.x
  • Considine J., Martin R., Smit D., Winter C. & Jenkins J. (2006). Emergency nurse practitioner care and emergency department patient flow: case-control study. Emerg Med Australas, 18(4), 385-390. doi: 10.1111/j.1742-6723.2006.00870.x
  • Cooper S., O'Carroll J., Jenkin A. & Badger B. (2008). Emergency care practitioners (ECP): practice and performance in the UK West country--a case study. Int Emerg Nurs, 16(3), 180-184. doi: 10.1016/j.ienj.2008.04.004
  • Currie J., Edwards L., Colligan M. & Crouch, R. (2007). A time for international standards? Comparing the Emergency Nurse Practitioner role in the UK, Australia and New Zealand. Accid Emerg Nurs, 15(4), 210-216. doi: 10.1016/j. aaen.2007.07.007
  • Di Tommaso F., Falasca P., Rossi A., & Lolli V. (2008). Pronto Soccorso: verso un uso responsabile. Prospettive Sociali e Sanitarie, 21, 4-6.
  • Dinh M., Walker A., Parameswaran A. & Enright N. (2012). Evaluating the quality of care delivered by an emergency department Fast Track unit with both nurse practitioners and doctors. Australas Emerg Nurs J, 15(4), 188-194. doi: 10.1016/j.aenj.2012.09.001
  • Ezra D. G., Mellington F., Cugnoni H. &Westcott M. (2005). Reliability of ophthalmic accident and emergency referrals: a new role for the emergency nurse practitioner? Emerg Med J, 22(10), 696-699. doi: 10.1136/emj.2004.018010
  • Fordyce J., Blank F.S.J., Pekow P., Smithline H.A., Ritter G., Gehlbach S., Benjamin E., Henneman P.L. (2003). Errors in a busy emergency department. Annals of Emergency Medicine, 42(3), 324-333
  • Griffin M. & Melby V. (2006). Developing an advanced nurse practitioner service in emergency care: attitudes of nurses and doctors. J Adv Nurs, 56(3), 292-301. doi: 10.1111/j.1365-2648.2006.04025.x
  • Heath S. M., Bain R. J., Andrews A., Chida S., Kitchen S. I. & Walters M. I. (2003). Nurse initiated thrombolysis in the accident and emergency department: safe, accurate, and faster than Fast Track. Emerg Med J, 20(5), 418-420.
  • Hoskins R. (2011). Evaluating new roles within emergency care: a literature review. Int Emerg Nurs, 19(3), 125-140. doi: 10.1016/j.ienj.2010.09.003
  • Hoskins R. (2012). Interprofessional working or role substitution? A discussion of the emerging roles in emergency care. J Adv Nurs, 68(8), 1894-1903. doi: 10.1111/j.1365-2648.2011.05867.x
  • Hoyt K. S., Coyne E. A., Ramirez E. G., Peard A. S., Gisness C. & Gacki-Smith J. (2010). Nurse Practitioner DelphiStudy: competencies for practice in emergency care. J Emerg Nurs, 36(5), 439-449. doi: 10.1016/j.jen.2010.05.001
  • Jennings N., Lee G., Chao K. & Keating S. (2009). A survey of patient satisfaction in a metropolitan Emergency Department: comparing nurse practitioners and emergency physicians. Int J Nurs Pract, 15(3), 213-218. doi: 10.1111/j.1440-172X.2009.01746.x
  • Konnyu K. J., Kwok E., Skidmore B. & Moher D. (2012). The effectiveness and safety of emergency department short stay units: a rapid review. Open Med, 6(1), e10-16.
  • Lee G., Jennings N., & Bailey M. (2007). An exploration of staff knowledge on the nurse practitioner's role in the emergency department. Accid Emerg Nurs, 15(2), 79-87. doi: 10.1016/j.aaen.2007.01.002
  • Mason S., Fletcher A., McCormick S., Perrin J. & Rigby A. (2005). Developing assessment of emergency nurse practitioner competence--a pilot study. J Adv Nurs, 50(4), 425-432. doi: 10.1111/j.1365-2648.2005.03408.x
  • McGee L. A. & Kaplan L. (2007). Factors influencing the decision to use nurse practitioners in the emergency department. J Emerg Nurs, 33(5), 441-446. doi: 10.1016/j.jen.2006.10.019
  • Megahy A. & Lloyd M. (2004). Managing minor injuries. Emerg Nurse, 12(5), 14-16.
  • Mengoni A. & Rappini V. (2007). La domanda non urgente al pronto soccorso: un'analisi. Mecosan, 62, 61-82.
  • Mills A. C. & McSweeney M. (2005). Primary reasons for ED visits and procedures performed for patients who saw nurse practitioners. J Emerg Nurs, 31(2), 145-149. doi: 10.1016/j.jen.2005.01.002
  • Nash K., Zachariah B., Nitschmann J. & Psencik B. (2007). Evaluation of the Fast Track unit of a university emergency department. J Emerg Nurs, 33(1), 14-20; quiz 90. doi: 10.1016/j.jen.2006.08.003
  • O'Connell J. & Gardner G. (2012). Development of clinicalcompetencies for emergency nurse practitioners: a pilot study. Australas Emerg Nurs J, 15(4), 195-201. doi: 10.1016/j.aenj.2012.10.004
  • OECD Health Data 2013. http://stats.oecd.org consultazione: 4 aprile 2013
  • Oredsson S., Jonsson H., Rognes J., Lind L., Goransson K. E., Ehrenberg A., Farrohknia N. (2011). A systematic review of triage-related interventions to improve patient flow in emergency departments. Scand J Trauma Resusc Emerg Med, 19, 43. doi: 10.1186/1757-7241-19-43
  • Parker M. (2008). Emergency nurse practitioner management of tetanus status and tetanus-prone wounds. Int Emerg Nurs, 16(4), 266-271. doi: 10.1016/j.ienj.2008.05.009
  • Patel H., Celenza A. & Watters T. (2012). Effect of nurse initiated X-rays of the lowerlimb on patienttransit time through the emergency department. Australas Emerg Nurs J, 15(4), 229-234. doi: 10.1016/j.aenj.2012.07.001
  • Quattrini V. & Swan B. A. (2011). Evaluating care in ED Fast Tracks. J EmergNurs, 37(1), 40-46. doi: 10.1016/j.jen.2009.10.016
  • Radice C., Ghinaglia M., Doneda R., Bollini G. (2013). "See and Treat" in Pronto Soccorso: aspetti legali e responsabilití professionale infermieristica. Professioni Infermieristiche, 66(3), 175-181.
  • Rogers T., Ross N. & Spooner D. (2004). Evaluation of a 'See&Treat' pilot study introduced to an emergency department. Accid Emerg Nurs, 12(1), 24-27.
  • Rowe B. H., Villa-Roel C., Guo X., Bullard M. J., Ospina M., Vandermeer B., Holroyd B. R. (2011). The role of triage nurse ordering on mitigating overcrowding in emergency departments: a systematic review. Acad Emerg Med, 18(12), 1349-1357. doi: 10.1111/j.1553-2712.2011.01081.x
  • Sandhu H., Dale J., Stallard N., Crouch R. & Glucksman E. (2009). Emergency nurse practitioners and doctors consulting with patients in an emergency department: a comparison of communication skills and satisfaction. Emerg Med J, 26(6), 400-404. doi: 10.1136/emj.2008.058917
  • Thrasher C. & Purc-Stephenson R. (2008). Patient satisfaction with nurse practitioner care in emergency departments in Canada. J Am Acad Nurse Pract, 20(5), 231-237. doi: 10.1111/j.1745-7599.2008.00312.x
  • Van der Linden C., Lindeboom R., van der Linden N. & Lucas C. (2012). Managing patient flow with triage streaming to identify patients for Dutch emergency nurse practitioners. Int Emerg Nurs, 20(2), 52-57. doi: 10.1016/j.ienj.2011.06.001
  • Wilson A. & Shifaza F. (2008). An evaluation of the effectiveness and acceptability of nurse practitioners in an adult emergency department. Int J Nurs Pract, 14(2), 149-156. doi: 10.1111/j.1440-172X.2008.00678.x
  • Wood C., Wettlaufer J., Shaha S. H. & Lillis K. (2010). Nurse practitioner roles in pediatric emergency departments: a national survey. Pediatr Emerg Care, 26(6), 406-407. doi: 10.1097/PEC.0b013 e3181e057b8