急诊危重指数联合改良早期预警评分在急诊分诊患者中的应用  

Application of Emergency Severity Index and Modified Early Warning Score in Triage Patients

作　　者：韩凤玉[1] 闫凤华[1] 马亮亮 刘静[1] 田芳[1] 保金涛 杨立山[1] Han Fengyu;Yan Fenghua;Ma Liangliang(The General Hospital of Ningxia Medical University,Yinchuan Ningxia 750004,China)

机构地区：[1]宁夏医科大学总医院,宁夏银川750004

出　　处：《齐鲁护理杂志》2018年第14期8-10,共3页Journal of Qilu Nursing

基　　金：宁夏自治区卫计委重点科研计划课题(编号:2016-NW-012)

摘　　要：目的:探讨急诊危重指数(ESI)联合改良早期预警评分(MEWS)在急诊分诊患者中的应用效果。方法:将2016年10月1日~2017年1月31日就诊的20842例急诊患者作为对照组,采用ESI评分进行分诊;将2017年2月1日~5月31日就诊的23786例急诊患者作为观察组,采用ESI联合MEWS评分进行分诊。比较两组分诊准确率、候诊时间、危重患者识别正确率、24 h不良事件发生率、72 h非计划转入抢救室率、自主循环恢复(ROSC)率以及分诊耗时。结果:观察组分诊准确率、危重患者识别正确率高于对照组(P<0.01);观察组24 h不良事件发生率、72 h非计划转入抢救室率低于对照组(P<0.01);观察组患者Ⅱ、Ⅲ、Ⅳ级平均候诊时间短于对照组(P<0.05);观察组ROSC成功率高于对照组,对照组分诊耗时短于观察组,但差异均无统计学意义(P>0.05)。结论:ESI联合MEWS可提高分诊效能和分诊准确度,降低因分诊导致的不良事件发生率,对提高急诊医疗质量有一定帮助。Objective： To explore the application effect of emergency severity index combined with modified early warning score in critical triage patients. Methods： The 20842 emergency patients who were seen from October 1,2016 to January 31,2017 were used as a control group. The ESI score was used for the triage; the 23786 emergency patients who visited from February 1,2017 to May 31,2017 were taken as the observation group used ESI and MEWS scores for triage. The accuracy of the two components,the waiting time,the correct rate of identification of critical patients,the incidence of adverse events for 24 hours,the rate of non-planned transfer to the rescue room for 72 hours,the rate of recovery of spontaneous circulation（ROSC）,and time-consuming division were compared. Results： The accuracy rate of component diagnosis and accuracy of critical patients were higher than that of the control group（P〈0. 01）. The incidence of adverse events at 24 hours and the rate of unplanned transfer to emergency room at 72 hours were lower in the observation group than in the control group（P〈0. 01）. The average waiting time for patients in the observation group Ⅱ,Ⅲ and Ⅳ was shorter than that in the control group（P〈0. 05）. The success rate of ROSC in the observation group was higher than that in the control group,and the consumption of the control component was shorter than that in the observation group,but the difference was not statistically significant（P〈0. 05）. Conclusion： ESI combined with MEWS can improve the efficiency and accuracy of triage,reduce the incidence of adverse events caused by triage,and help to improve the quality of emergency medical care.

关 键 词：急诊危重指数 改良早期预警评分 急诊分诊 

分 类 号：R473.6[医药卫生—护理学]