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Hänvisning på akutmottagning: Triagesjuksköterskans erfarenheter av att hänvisa patienter till annan vårdnivå
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
2017 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Abstrakt

Bakgrund: Flertalet av patienterna vilka söker akuten är inte i behov av akutsjukvård. Sjuksköterskor på akutmottagningarna kan idag hänvisa patienter till annan vårdnivå så som primärvård eller till hemmet med egenvårdsråd.

 

Syfte: Syftet var att belysa triagesjuksköterskans erfarenhet av hänvisning till annan vårdnivå än akutmottagning.

 

Metod: Studien var en kvalitativ intervjustudie genomförd med semistrukturerade intervjuer. I studien ingick intervjuer med 12 sjuksköterskor, både med och utan specialistutbildning, vilka arbetar på akutmottagning samt har erfarenhet av hänvisning av patienter till annan vårdnivå. Kvalitativ innehållsanalys har använts för att bearbeta insamlad data.

 

Resultat: Triagesjuksköterskans erfarenhet av att hänvisa patienter till annan vårdnivå tolkades utifrån följande teman för att belysa olika faktorer som påverkar sjuksköterskans handling på en akutmottagning; faktorer som påverkar hänvisning, professionella stöd och handläggningsstrategier vid hänvisning. Resultatet visade att respondenterna upplever hänvisning som komplext och stundtals svårt där sjuksköterskan känner sig osäker, samtliga respondenter uppgav att de hade erfarenhet av patienter som uppträder agiterat samt hotfullt vid hänvisning, flertalet uttryckte därför att de kände sig otrygga på sin arbetsplats, de uttryckte även att erfarenhet samt klinisk blick var av stor betydelse vid hänvisning av patienter.

 

Slutsats: Författarnas kliniska slutsats är att respondenterna anser att möjligheten till att kunna hänvisa patienterna till en annan vårdnivå är av stor patientnytta. Detta då patienten får adekvat och rätt vård från början relaterat till deras sjukdomstillstånd vilket även kan leda till att väntetiden på akutmottagningen minskar. Mer utbildning liksom beslutstöd behövs för att göra sjuk sjuksköterskor tryggare med sin hänvisning. Författarna anser även att studien ger viktiga infallsvinklar inom problemområdet som kan vara användbara i en kommande yrkesroll.

Abstract [en]

Abstract

Background: The majority of patients who seek emergency care, are not in need of it. Nurses at emergency departments can refer patients to other type of care, such as primary care or to the home with self-care advices. Referral are often carried out independent and therefore the nurses requires a high level of expertise as well as good communication skills.

 

Purpose: The aim of the study is to highlight the triage nurse's experience of referral of patients from the emergency department to other care givers such as primary healthcare and self-care.

 

Method: The study was a qualitative interview study, conducted with semi-structured interviews. The study included interviews with 12 nurses, both with and without specialisteducation, who works in the emergency department and has experience of referring patients to other level of care. Content analysis has been used to process the collected data

 

Result: The triagenurse experience of referring patients to other care was interpreted based on the following themes to highlight the various factors affecting the nurse's action in an emergency; factors affecting reference, professional support and management strategies by reference. The results showed that respondents perceive reference as complex and sometimes difficult where the nurse feels insecure, all respondents stated that they had the experience of patients who appear agitated and threatening at time of referral, the majority of the respondents therefore expressed they felt insecure in their workplace, they also expressed that the experience and clinical gaze was of great importance in referring patients.

 

Conclusion: The authors' clinical conclusion is that the respondents believe that the ability to be able to refer patients to other level of care is of significant patient benefit. This resulting in the patient receiving adequate care from the start related to their disease severity which also can lead to that the waiting time at the emergency room is reduced. More education and decision support is needed to make nurses more secure whilst performing referrals. The authors also believe that the study provides important insights in the problem area that may be useful in a future profession.

Place, publisher, year, edition, pages
2017. , 57 p.
Keyword [en]
nurse, experience, referral, emergency department, primary helthcare center, selfe care
Keyword [sv]
sjuksköterska, erfarenheter, hänvisning, akutmottagning, primärvård, egenvård
National Category
Other Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-62424OAI: oai:DiVA.org:lnu-62424DiVA: diva2:1088254
Subject / course
Vårdvetenskap
Educational program
Specialist Nursing Programme, with Specialism in Emergency Care, 60 credits
Supervisors
Examiners
Available from: 2017-04-12 Created: 2017-04-11 Last updated: 2017-04-12Bibliographically approved

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