基于业务流程再造理论的急性缺血性脑卒中病人静脉溶栓流程的现况分析  

Analysis of status quo of venous thrombolysis process for patients with acute ischemic stroke based on business process reengineering theory

作　　者：张琳[1] 施雁[1] 朱晓萍[1,2] 

机构地区：[1]同济大学附属第十人民医院 [2]第二军医大学护理学院

出　　处：《护理研究（中旬版）》2017年第6期2104-2107,共4页Chinese Nursing Researsh

基　　金：上海市卫生和计划生育委员会科研课题;编号:201540320

摘　　要：[目的]基于业务流程再造理论分析急性缺血性脑卒中病人静脉溶栓流程的现状及其院内延误的影响因素。[方法]以现场追踪调查法对47例急性缺血性脑卒中静脉溶栓病人进行调查,并绘制因果分析图分析院内延误关键环节的影响因素。[结果]病人入院至CT出报告、入院至检验结果出报告、入院至溶栓用药中位时间分别为47.0min,92.0min,112.5min,均高于国际标准,且入院至溶栓用药时间≤60min的百分比仅为5%;因果分析图显示院内延误的影响因素为医院急救组织管理体系缺失、脑卒中信息化平台未完善、专业业务培训不足和质量监控有待改进等。[结论]构建急救组织管理体系、研发急诊脑卒中信息化共享平台、加强专业业务培训、实施持续性质量改进计划等措施是缩短院内延误时间的关键因素。Objective:To analyze the status quo of intravenous thrombolytic therapy in patients with acute ischemic stroke and the influencing factors of hospital delay based on the theory of business process reengineering.Methods:A total of 47 cases of patients with acute ischemic stroke were enrolled and survey with site tracking method in this study.The causal analysis was used to analyze the influencing factors of key points in the hospital.Results:The median time of the patients admitting to the CT report,admission to the test results reported and admission to thrombolytic therapy were respectively 47.0 min,92.0 min and 112.5 min.They were higher than the international standard,and admission to thrombolytic drug time ≤ 60 min percentage was only 5%;causal analysis showed that the impact factors of hospital delay factors was the hospital emergency management system missing,stroke information platform was not perfect,lack of professional business training and quality control to be improved and so on.Conclusion:It was the key factor to shorten the delay time in the hospital by constructing the first aid organization management system,developing the information platform of emergency stroke,strengthening the training of professional business and implementing the continuous quality improvement plan.

关 键 词：业务流程再造理论 急性缺血性脑卒中 静脉溶栓 院内延误 影响因素 急救组织管理体系 信息化共享平台 业务培训 

分 类 号：R473.5[医药卫生—护理学]