非创伤性急腹症患者预检分诊管理的循证实践  

Evidence-based practice of pre-examination and triage management for patients with non-traumatic acute abdomen

作　　者：郭莎莎 侯永超[2] 樊晶晶[2] 杨秀芝 吴春梅[3] 王菊子[4] Guo Shasha;Hou Yongchao;Fan Jingjing;Yang Xiuzhi;Wu Chunmei;Wang Juzi(Graduate School,Shanxi University of Traditional Chinese Medicine,Jinzhong 030600,China;Emergency Department of Shanxi Provincial People's Hospital,Taiyuan 030012,China;Operating Room of Shanxi Provincial People′s Hospital,Taiyuan 030012,China;Nursing Department of Shanxi Provincial People′s Hospital,Taiyuan 030012,China)

机构地区：[1]山西中医药大学研究生学院,晋中030600 [2]山西省人民医院急诊科,太原030012 [3]山西省人民医院手术室,太原030012 [4]山西省人民医院护理部,太原030012

出　　处：《中国实用护理杂志》2022年第7期492-500,共9页Chinese Journal of Practical Nursing

基　　金：山西省留学人员科技活动择优资助项目(20210018)。

摘　　要：目的将非创伤性急腹症患者预检分诊管理的最佳证据应用于临床实践, 并评价其效果。方法采用便利抽样法, 选取2021年1—5月山西省人民医院急诊科15名护士和收治的237例非创伤性急腹症患者作为研究对象。将循证方案应用前的114例患者作为基线审查组, 将应用后的123例患者作为后效评价组。遵循JBI循证护理中心临床证据实践应用系统的标准程序, 采用自身前后对照试验比较证据应用前后分诊护士知信行情况, 各审查指标依从性;采用非同期对照试验比较2组患者预检分诊时间及分诊准确率的变化。结果基线审查组分诊护士对非创伤性急腹症预检分诊知信行问卷总分为(98.00 ± 6.56)分, 后效评价组为(114.20 ± 3.88)分, 差异有统计学意义(t=8.62, P<0.05);后效评价组审查指标1~9、12、13、15~17依从性均明显提高, 差异有统计学意义(χ^(2)值为11.46~123.06, 均P<0.05);后效评价组, 除指标6外, 依从性<80%指标的依从性均上升到80%以上;基线审查组患者分诊准确率为84.21%(96/114), 后效评价组为93.50%(115/123), 差异有统计学意义(χ^(2)=5.22, P<0.05);后效评价组分诊时长为2.00(1.00, 4.00) min, 短于基线审查组的3.00(2.00, 4.63) min, 差异有统计学意义(Z=-3.18, P<0.05)。结论非创伤性急腹症预检分诊最佳证据的应用, 可改善非创伤性急腹症预检分诊的护理实践, 提高非创伤性急腹症分诊准确率, 缩短分诊时长。Objective To apply the best evidence of pre-examination and triage management of patients with non-traumatic acute abdomen to clinical practice and evaluate its effects.Methods Using convenience sampling method,15 nurses and 237 patients with non-traumatic acute abdomen admitted in the emergency department of Shanxi Provincial People′s Hospital from January to May 2021 were selected as the research objects,114 cases as the baseline review group and 123 cases as the after-effect evaluation group.Following the clinical evidence practice application of JBI Evidence-Based Nursing Center Systematic standard procedures,using self before-after control study to compare the knowledge and behavior of triage nurses before and after evidence application,and compliance with each review index;using a non-contemporaneous controlled trial to compare the changes of pre-examination and triage time and triage accuracy between two groups.Results After the application of evidence,the score of the triage nurses on the pre-examination and triage of non-traumatic acute abdomen increased from 98.00±6.56 in the after-effect evaluation group to 114.20±3.88 in the base-line review group,and the difference was statistically significant(t=8.62,P<0.05);after the application of evidence,the compliance with indicators 1-9,12,13,15-17 was significantly improved and the difference was significant(χ^(2)values were 11.46-123.06,all P<0.05).After the application of evidence,the compliance rate of those indicators<80%increased to more than 80%except indicator 6,the accuracy of patient triage rose from 84.21%(96/114)to 93.50%(115/123)with a statistically significant difference(χ^(2)=5.22,P<0.05);after the application of the evidence,the triage time was 2.00(1.00,4.00)min,shorter than 3.00(2.00,4.63)min in the base-line review group,and the difference was statistically significant(Z=-3.18,P<0.05).Conclusions The application of the best evidence of pre-examination and triage for non-traumatic acute abdomen can improve the nursing practice of non-tr

关 键 词：非创伤性急腹症 预检分诊 急诊 循证实践 

分 类 号：R473.6[医药卫生—护理学]