“一键式启动”急救护理路径  

Nursing Path Management in Application of One-button Starting Catheter Laboratories

作　　者：张勤[1] 李晓彤[1] 胡林婕[1] 徐超凡[1] 张建秋[1] 纪军[2] 黄文诺[3] ZHANG Qin LI Xiaotong HU Linjie XU Chaofan ZHANG Jianqiu JI Jun HUANG Wennuo(Medical Image Center, Subei People＇s Hospital of Jiangsu Province, Yangzhou 225001 Department of Cardiovasology, Subei People＇s Hospital of Jiangsu Province, Yangzhou 225001 Department of Intervention, Subei People＇s Hospital of Jiangsu Province, Yangzhou 225001)

机构地区：[1]江苏省苏北人民医院医学影像中心,扬州225001 [2]江苏省苏北人民医院心内科,扬州225001 [3]江苏省苏北人民医院介入科,扬州225001

出　　处：《解放军医院管理杂志》2017年第9期884-886,共3页Hospital Administration Journal of Chinese People's Liberation Army

摘　　要：目的探讨一键式启动急救护理路径模式运用前后,急诊经皮冠状动脉介入术(PCI)过程中关键指标的变化情况及手术护理配合效果。方法对2016年急诊直接行PCI的急性心肌梗死299例患者,运用一键式启动急救护理路径管理模式分别从术前、术中、术后三阶段制定管理路径,融入节点管理,实施手术护理配合。以2015年166例患者作为回顾性对照,比较该模式运用前后,导管室启动时间和"门球"(D2B)时间、护理配合效果。结果 2015年导管室平均启动时间32分钟和D2B平均时间155分钟显著长于2016年导管室平均启动时间18分钟和D2B平均时间88分钟,术中配合抢救成功率98%(3例患者因心脏破裂抢救无效死亡),术后冠状动脉血流均达到TIMIⅡ~Ⅲ级,符合再通标准,无护理并发症发生。结论一键式启动急救护理路径管理模式可有效提高手术配合效率,缩短心肌再灌注时间,利于提高团队快速应答能力和手术护理配合内涵。Objective To explore the changes of major indexes and effects of operation nursing cooperation before and after the nursing path management of one-button starting the Catheter Laboratories was used in emergency percutaneous coronary intervention（ PCI）. Methods We reviewed 299 cases of acute myocardial infarction（ AMI） that accepted PCI directly. We used management model of one-button starting the Catheter Laboratories emergency nursing path to draft managing path with key point management,then carried on operation nursing cooperation. We reviewed 166 cases in 2015 as controls. We compared the Catheter Laboratories starting time,Door-to-Balloon time and nursing cooperation effects before and after the model was used. Results The average time of the Catheter Laboratories starting in 2015 was 32 min and in 2016 was 18 min. The average time of D2 B time in2015 was 155 min and in 2016 was 88 min. Both the times were longer in 2015 than in 2016. Rescue success rate was 98%. 3 cases rescued invalid because of cardiac rupture. Coronary blood flow all achieved Level 2th to 3rd after PCI,according with the standard of coronary recanalization. None of nursing complication occurred. Conclusion Managing model of one-button starting emergency nursing path can effectively improve the efficiency of operation cooperation and shorten the time of myocardial reperfusion. It can also improve the ability of team quick answer and enrich operation cooperation connotation.

关 键 词：一键式启动 经皮冠状动脉介入术 急救 护理路径 管理 

分 类 号：R197.32[医药卫生—卫生事业管理]