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目的 急性心筋梗塞発症から再灌流治療までの危機的状況にある患者に対する救急看護師の看護実践を明らかにする．方法 2 次救急外来や 3 次救急の救命救急センターに勤務する13病院の救急経験 5 ～10年の救急看護師10名に半構造化面接法により質的記述的に分析した．結果 【最優先は急性心筋梗塞の重症度の判断，急変予測・チームでの情報共有】【家族と患者情報を共有しケアへの参加の提供】【生命の危機的状況でも余裕を持って接することで患者が前向きに安心して治療を受けられる援助】【死の恐怖や胸痛の軽減のためには信頼関係を構築し患者の代弁者となること】【救急現場の倫理を持ちつつ行うケア】【緊急時であっても患者が納得できる個別性を見極めた説明】の 6 カテゴリが得られた．考察 救急看護師は再灌流治療に向け医療チームによる多職種協働，危機的状況の中患者が安心して治療を受ける看護実践，また緊急時でも患者の尊厳を守る看護実践を行った．Purpose To clarify the nursing practice of emergency nurses for patients in critical condition, from the onset of acute myocardial infarction to reperfusion therapy.Method A total of 10 emergency nurses with five to 10 years of emergency care experience from 13 hospitals, working in secondary and tertiary care emergency departments, were analyzed qualitatively and descriptively using semi-structured interviews. Results The following six categories of care were identified: “the highest priority was given to determining the severity of acute myocardial infarction, predicting sudden changes and sharing information with the team,” “sharing patient information with family members to enable their participation in care,” “helping patients receive treatment positively and reassuringly by treating them with a relaxed attitude even in life-threatening situations,” “building trust and becoming an advocate for patients, to reduce their fear of death and chest pain,” “providing care while maintaining ethics in the emergency setting,” and “providing personalized explanations that are acceptable to the patient, even in an emergency.”Discussion The emergency nurses practiced nursing care in collaboration with a multidisciplinary medical team to provide reperfusion therapy, so that patients feel safe and secure during a crisis. They also practiced nursing care that protects patients’ dignity in an emergency. |
