Abdulkadir ATALAN, Cem Çağrı DÖNMEZ, Yasemin AYAZ ATALAN

Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi

Acil servisler sağlık sistemlerin temel taşını oluşturmaktadırlar. Bu çalışmada, Türkiye’deki acil servislerin çalışma sistemleri incelenmiştir. Mevcut durumdaki acil servislere ait yoğunluklar ölçülemez hale gelmektedir. Bunun başlıca nedeni acil durumda olmayan hastaların acil servisleri meşgul etmesidir. Bu çalışma ile acil servislerde acil olmayan ya da ayakta tedavi edilebilecek olan hastaların yüksek-eğitimli uzman hemşireler (YUH) tarafından tedavi edilmesi önerilmiştir. Bu durumda daha fazla hasta tedavi edilmesi, hastaların bekleme sürelerinin ve dolayısıyla hastaların acil servislerde kalma sürelerinin azaltılması amaçlanmıştır. Ayrıca acil servislerde istihdam edilen kaynakların verimliliğinin arttırılması hedeflenmiştir. 1/24 ve 7/24 esasına göre uygulanan simülasyon örneği ile YUH istihdamı sağlanarak tedavi edilen hasta sayısında 1/24 esasına göre %26,71 ve 7/24 esasına göre %15,13 oranında artış sağlandığı görülmüştür. Hastaların acil servise kayıt yaptıkları andan itibaren tedavi olmak için bekledikleri süre 1/24 esasına göre %38,67 ve 7/24 esasına göre %53,66 oranlarında iyileşme sağlanarak bekleme zamanı düşürülmüştür. Aynı şekilde bir hastanın tedavi olmak için acil servislerde geçirmesi gereken süre ortalama 82,46 dakikadan 53,97 dakikaya düşürülmüştür. Bulgular arasında, acil servislerde istihdam edilen kaynaklardan yeteri kadar verim alınamamasıyla YUH istihdamı sayesinde kaynaklara ait verimlilik oranlarında bir denge sağlandığı görülmüştür. Ek olarak, YUH istihdamı ile doktorların çalışma yoğunluklarının azaldığı tespit edilmiştir.

Anahtar Kelimeler:

Türkiye Acil Servis Sistemi, Yüksek Eğitimli Uzman Hemşire, Simülasyon, Acil Servis Kaynakları

Implementation of Simulation for the Improvement of Emergency Service Quality by High-Educated Specialist Nurses Employment: Turkish Health System

Emergency departments are the cornerstone of health care systems. In this study, the work of the emergency services system in Turkey were examined. The intensities of the emergency services are becoming immeasurable in the present situation. This is mainly due to the fact that the majority of patients who come to emergency services are not urgent in emergency departments. This study suggests that patients who are not urgent or outpatient in emergency services should be treated by highly-educated specialist nurses (YSN). In this case, it is aimed to treat more patients, to reduce the waiting time of the patients and therefore the duration of the patients' stay in the emergency services. It is also aimed to increase the efficiency of the resources employed in emergency services. According to the simulation example applied on 1/24 and 7/24 basis, it was observed that the number of patients treated by providing employment of YUH was increased by 26,71% on the basis of 1/24 and 15,13% on the basis of 7/24. The waiting time for treatment was reduced by 38.67% on 1/24 basis and 53.66% on 7/24 basis, respectively, from the time the patients were enrolled in emergency services. Likewise, the time required for a patient to be treated in emergency services for treatment was reduced from an average of 82.46 minutes to 53.97 minutes. Among the findings, it has been seen that the efficiency of the employment of YUH has provided a balance in the efficiency rates of the resources by not getting the efficiency as high as the resources employed in the emergency services. In addition, it has been found that the employment intensity of physicians decreases with the employment of YUH.

Keywords:

Turkey Emergency Service System, High Educated Specialist Nurses, Simulation, Resources of Emergency Service,

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