急性中毒患者院内急救流程再造的实践与效果评价  

Practice and effects of inhospital emergency process reengineering for patients with acute poisoning

作　　者：楼秋英[1] 张伟[2] 李舒霞[1] 吴敏娟[2] 赖登攀[1] 潘晓青[1] 潘勇莉 Lou Qiuying;Zhang Wei;Li Shuxia;Wu Minjuan;Lai Dengpan;Pan Xiaoqing;Pan Yongli(Emergency Department,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;Nursing Department,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院急诊科,杭州310015 [2]杭州师范大学附属医院护理部,杭州310015

出　　处：《中华现代护理杂志》2018年第23期2811-2815,共5页Chinese Journal of Modern Nursing

基　　金：杭州市科技计划引导项目（20163501Y10）

摘　　要：目的探讨急性中毒患者院内急救流程再造的实践效果。方法2016年3月杭州师范大学附属医院急诊科实施再造后院内中毒急救流程，从细化预检接诊患者、中毒应急小组评估、快速洗胃、转运、洗胃同步血液净化小组快速准备、急诊重症监护室（EICU）单位准备6个方面工作着手，优化原有急救流程，将其应用于急性中毒患者。比较2015年3月-2016年2月（流程再造前）和2016年3月-2017年2月（流程再造后）急性中毒患者抢救效率。结果再造后患者从入院至洗胃开始所用时间（8．91±5．29）min、洗胃持续时间（31．86±8．42）min，均比再造前缩短，差异有统计学意义0值分别为3．397、4．028；P〈0．01）。再造后患者人院至血液净化管路开通时间（176．59±88．73）min、至血液灌流开始时间（229．35±108．79）min，均比再造前提前，差异有统计学意义“值分别为3．600、3．550；P〈0．01）。结论再造的院内中毒急救流程更科学、便捷，有利于提高急性中毒患者的抢救效率。Objective To explore the effects of inhospital emergency process reengineering for patients with acute poisoning. Methods Emergency Department of the Affiliated Hospital of Hangzhou Normal University implemented inhospital poisoning emergency process reengineering in March 2016. This implementation optimized original emergency process and applied it in patients with acute poisoning beginning with 6 aspects including refining precheck patients, assessment of poisoning emergency response group, fast gastrolavage, transportation, gastrolavage combined with blood purification group rapid preparation, emergency intensive care unit preparation. We compared the rescue efficiency of patients with acute poisoning before （from March 2015 to February 2016） and after （from March 2016 to February 2017） process reengineering. Results After process reengineering, the time from being admitted to hospital to beginning gastrolavage and the duration of gastrolavage was （8.91±5.29）min and （31.86 ± 8.42）min respectively shorter than those before process reengineering with significant differences （t=3.397, 4.028; P 〈 0.01）. After process reengineering, the time from being admitted to hospital to opening blood purification tubes （176.59 ± 88.73）min and from being admitted to hospital to starting blood perfusion （229.35±108.79）rain were significantly sooner than those before process reengineering （t=3.600, 3.550; P 〈 0.01）. Conclusions The inhospital emergency process reengineering is scientific and convenient. It is propitious to improve rescue efficiency of patients with acute poisoning.

关 键 词：中毒 护理 流程再造 

分 类 号：R473.5[医药卫生—护理学]