标准化分级院内转运方案在急诊危重症患者中的应用分析  

Implementation analysis on in-hospital standardized classification and transportation system for critically ill patients in emergency department

作　　者：杨俐俐[1] 高鹏[2] Yang Lili;Gao Peng(Department of Emergency,China-Japan Friendship Hospital,Beijing 100029,China;Department of Education,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院急诊科,北京100029 [2]中日友好医院教育处,北京100029

出　　处：《中国中西医结合急救杂志》2021年第3期334-338,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家临床重点专科建设项目(2013-544)。

摘　　要：目的建立危重症患者标准化分级院内转运方案并评价其应用效果.方法选择2018年7月至2019年6月中日友好医院急诊抢救室进行院内转运的危重症患者作为研究对象,以2018年7月至12月采用常规方法转运期间转运的1075例患者作为对照组,以2019年1月至6月采用标准化分级方案转运期间转运的1112例患者作为观察组.比较两组患者的转运时间、转运过程中突发事件的发生情况、危重症患者转运交接单信息补充率的差异.结果与对照组比较,观察组的单纯性转运路途时间、交接患者滞留时间以及检查等待时间均明显缩短〔转运至检查科室路途时间(min):14.73±2.50比18.21±3.10,转运至治疗性科室路途时间(min):8.09±2.48比9.41±3.35,转运至重症监护病房(ICU)路途时间(min):15.94±2.73比18.70±3.37,转运至普通病房路途时间(min):14.68±2.56比16.66±3.48,治疗性科室交接时间(min):2.99±0.72比3.91±1.23,ICU交接时间(min):6.11±1.87比7.91±5.48,普通病房交接时间(min):4.21±1.78比5.84±2.06,检查等待时间(min):3.97±1.59比5.21±2.42,均P<0.05〕;并发症发生率以及因病情加重返回抢救室发生率均明显降低〔心律失常:0.4%(5/1112)比1.3%(14/1075),血压(BP)下降:1.0%(11/1112)比2.5%(27/1075),脉搏血氧饱和度(SpO_(2))下降:0.9%(10/1112)比2.0%(21/1075),意识改变:0.4%(4/1112)比1.1%(12/1075),呼吸心搏骤停:0.2%(2/1112)比0.8%(9/1075),重返抢救室发生率:9.4%(3/32)比27.7%(23/83),均P<0.05〕.两组间因检查等待时间过长返回抢救室的发生率以及转运交接单信息补充率比较差异均无统计学意义.结论标准化分级院内转运方案可缩短转运时间,降低患者院内转运并发症发生率以及因病情加重返回抢救室的发生率.Objective To establish an in-hospital standardized classification and transportation system and evaluate its implementation effect on critically ill patients in emergency department.Methods The critically ill patients in the emergency rescue room who were transported in the China-Japan Friendship Hospital from July 2018 to June 2019 were selected as the research objects.A total of 1075 patients who were transported in-hospital by conventional methods from July to December 2018 were in the control group,and 1112 patients who were transported by in-hospital standardized classification and transportation system from January to June 2019 were in the observation group.The transport time,the occurrence situation of incident event during transit process and the difference in the information supplement rate on the handover sheet of critically ill patients'transfer were compared between the two groups.Results After the implementation of the in-hospital standardized classification and transportation system,the time spent for a simple transit process in the pathway to a department and the time for patients'handover process at the target department in observation group were significantly shorter than those in the control group[transportation time in the pathway to a department for examination(minute):14.73±2.50 vs.18.21±3.10,transportation time in the way to a department for treatment(minute):8.09±2.48 vs.9.41±3.35,transportation time in the way to the intensive care unit(ICU,minute):15.94±2.73 vs.18.70±3.37,transportation time in the way to a general ward(minute):14.68±2.56 vs.16.66±3.48;handover time at the department for treatment(minute):2.99±0.72 vs.3.91±1.23,handover time at ICU(minute):6.11±1.87 vs.7.91±5.48,handover time at a general ward(minute):4.21±1.78 vs.5.84±2.06,waiting time for examination(minute):3.97±1.59 vs.5.21±2.42,all P<0.05].The incidence of complications in transit period in the observation group was lower than that in the control group[arrhythmia:0.4%(5/1112)vs.1.3%(14/1075),decrease

关 键 词：标准化分级 院内转运方案 急诊 危重症患者 

分 类 号：R47[医药卫生—护理学]