临床护理路径对重症创伤患者急救时效的影响  

Effect of Clinical Nursing Path on Time Window of Emergency Management of Severe Traumatic Patients

作　　者：许士海[1] 王进[1] 史菲[1] 管穗丽 谢曼英[1] XU Shi-hai;WANG Jin;SHI Fei;GUAN Sui-li;XIE Man-ying(Emergency Center,Shenzhen People＇s Hospital,the Second Clinical Medical College of Jinan University,Shenzhen 518020,China)

机构地区：[1]暨南大学第二临床医学院深圳市人民医院急诊中心,广东深圳518020

出　　处：《护理学报》2018年第13期29-32,共4页Journal of Nursing（China）

基　　金：广东省科技计划项目(2016A020215025)

摘　　要：目的探讨临床护理路径对重症创伤患者急诊救治时效的影响。方法我院急诊自2016年11月运行创伤临床护理路径,采用回顾性前后对照研究,以2015年10月—2016年10月收治的202例重症创伤患者作为对照组,2017年1—12月收治217例作为路径组。比较组间的采血、开通静脉、化验报告回报、送CT、CT报告、输血开始、骨盆外固定和急诊停留时间以及绿色通道时间窗达标率和急诊死亡率。结果运行CNP后,急诊重症创伤患者死亡率由7.4%下降至2.3%(χ~2=6.04,P<0.05),采血、开通静脉通路、血液报告、送计算机X线断层扫描时间、CT报告、输血开始、骨盆外固定和急诊停留时间均显著下降(P<0.01),绿色通道达标率明显改善(P<0.01)。结论急诊重症创伤护理临床路径的构建能降低重症创伤患者死亡率,缩短急诊救治时间节点,保证了重症创伤患者安全。Objective To explore the effect of clinical nursing path（CNP） on time window of emergency management of severe traumatic patients（STP）. Methods In November, 2016, CNP was introduced and operated in the emergency department of Shenzhen People＇s Hospital. A retrospective, before-after study was performed to compare the time window of emergency management for STPs.202 STPs from October, 2015 to October, 2016 were included in the control group, while 217 STPs from January to December, 2017 in the CNP group. Mortality was the main outcome. Other indicators included time from admission to blood extraction, venous access,blood test report, CT delivery, CT report, beginning of blood infusion, external fixation of pelvic fracture, emergency length of stay（LOS） and compliance rate of green channel time-window. Results After the operation of CNP, the mortality rate decreased from 7.4% to 2.3%（χ^2=6.04, P〈0.05）. The time for blood extraction, venous access, blood test report, CT delivery, CT report, the beginning of blood infusion, external fixation of pelvic fracture and emergency LOS was all shortened significantly（ P〈0.01） and the compliance rate of green channel time-window was also significantly improved（P〈0.01）. Conclusion CNP for STPs in emergency department improves the efficiency of rescue, and ensures the safety of patients.

关 键 词：临床护理路径 创伤 时间节点 急诊 

分 类 号：R471[医药卫生—护理学] C931.3[医药卫生—临床医学]