新型冠状病毒肺炎疫情期间线上快速预检分诊系统的构建及应用  

Construction and application of online rapid pre-screening and triage system during epidemic of coronavirus disease 2019

作　　者：王华芬 卢芳燕 盛迪[3] 俞玮 李琴[3] 梁廷波[1] 金朝汇 WANG Huafen;LU Fangyan;SHENG Di;YU Wei;LI Qin;LIANG Tingbo;JIN Chaohui

机构地区：[1]浙江大学医学院附属第一医院护理部,杭州市310003 [2]浙江大学医学院附属第一医院肝胆胰外科,杭州市310003 [3]浙江大学医学院附属第一医院急诊科,杭州市310003 [4]浙江核新同花顺网络信息股份有限公司

出　　处：《中华护理杂志》2020年第4期504-507,共4页Chinese Journal of Nursing

基　　金：浙江省科学技术厅2020年度重点研发计划应急攻关子课题七(2020C03123-07);浙江省医药卫生科技计划项目(2020KY124,2020KY128).

摘　　要：目的新型冠状病毒肺炎疫情时期构建发热门诊线上快速预检分诊系统,以智能、精确、快速完成预检分流,并为新型冠状病毒感染患者的预警管理提供决策支持。方法发热门诊线上快速预检分诊系统手机应用程序管理软件,操作平台分为患者自我报告操作平台和管理员监控平台。患者自我报告内容包括新型冠状病毒流行病学接触史、发热及呼吸道症状。从管理员监控平台调取2020年1月20日—2月3日发热门诊患者使用线上快速预检分诊系统的分诊时间、智能分诊符合率、患者满意度等数据,评价该系统的应用效果。结果共有1034例发热门诊患者完成线上快速预检分诊,智能决策分诊B区(疑似区域)174例(16.8%),经筛查后确定疑似新型冠状病毒肺炎65例(37.4%),最终确诊29例(44.6%);智能决策分诊A区(普通区域)860例(83.2%),就诊后无1例疑似及确诊病例。线上快速预检分诊耗时(1.94±0.87)min,较传统人工分诊耗时(4.03±2.15)min显著缩短,差异有统计学意义(t=-30.99,P<0.001);1010例(97.7%)患者对线上快速预检分诊表示满意,无投诉及不良事件发生。结论发热门诊线上快速预检分诊系统能早期识别新型冠状病毒肺炎高风险患者,确保疑似感染患者提前预警分流,缩短暴露时间;同时能有效缩短发热门诊候诊时间,降低院内交叉感染的风险,提高患者就诊满意度。Objective To develop an online rapid pre-screening and triage system during epidemic of coronavirus disease(COVID-19),and to accomplish intelligent,accurate,and quick pre-screening and triage,so as to provide the decision-support of early warning management for COVID-19 patients.Methods The online rapid pre-screening and triage system consists of 2 platforms,including patient self-report platform and administrator monitoring platform.The patient self-report platform included epidemiological history of COVID-19 exposure,fever and respiratory symptoms.The data of triage time,coincidence rate of intelligent triage and patient satisfaction from January 20 to February 3 in 2020 were collected from the administrator monitoring platform to evaluate the application effect of the system.Results A total of 1034 outpatients with fever completed the online pre-screeningand triage;174 patients(16.8%)were diagnosed by the intelligent decision-making triage to area B(area of suspected outpatients);65 patients(37.4%)were suspected with COVID-19 after the second triage;29 cases(44.6%)were finally diagnosed.Intelligent decision-making subdivision resulted in 860 cases(83.2%)in area A(general area),and there was no suspected and confirmed case found.The time for online rapid pre-screening and triage was(1.94±0.87)mins,which was significantly shorter than that of traditional manual triage(4.03±2.15)mins.The difference was statistically significant(t=-30.99,P<0.001);1010 patients(97.7%)were satisfied with the rapid pre-screening and triage,and no complaints or adverse events occurred.Conclusion The online rapid pre-screening and triage system in fever clinics can early detect high-risk patients with COVID-19,ensure early warning and triage of suspected infected patients,and shorten the exposure time.At the same time,it can effectively shorten the waiting time in fever clinics,reduce the risk of cross-infection in hospitals,and improve patients'satisfaction.

关 键 词：新型冠状病毒感染 信息化平台 预检分诊 护理 发热门诊 

分 类 号：R473[医药卫生—护理学]