成批伤事件过负荷应急响应能力指标体系的构建及其初步应用  

Development and application of index systems of emergency response to mass casualty incidents

作　　者：徐晓川 桂莉 刘晶晶 XU Xiaochuan;GUI Li;LIU Jingjing(Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学基础医学院学员十二队,上海200433 [2]海军军医大学护理系野战护理教研室,上海200433

出　　处：《中国急救复苏与灾害医学杂志》2022年第7期873-878,886,共7页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：上海市卫健委临床研究专项(编号:20194Y0450);军队护理创新与培育专项计划(编号:2021HL023)。

摘　　要：目的 构建成批伤事件现场和医院两个阶段的过负荷应急响应能力指标体系,为医疗系统进行过负荷能力评价和培训提供参考。方法 基于文献研究和CO-S-TR理论模型初拟指标体系,通过德尔菲专家咨询法对12名专家进行咨询,运用层次分析法和平均分配法计算各指标权重,对指标筛选修正。依据确定的指标体系构建成批伤应急响应能力测评检核表,将其用于医务人员成批伤桌面推演,由三名导师分别独立进行评分。结果2轮专家咨询表的回收率均为100%;专家权威系数分别为0.85、0.88;专家意见和谐系数分别为0.238、0.203,均有统计学意义(P<0.001)。形成了一个事件现场应急响应的一级指标3项、二级指标12项、三级指标30项;医院应急响应的一级指标3项、二级指标12项,三级指标38项的指标体系。使用检核表对157名医务人员进行的7轮桌面推演评价显示,该检核表评价者间一致性良好(P<0.001)。结论 构建了系统科学的成批伤事件不同阶段的过负荷应急响应能力指标体系,能够为评价医疗系统的过负荷能力及相应培训提供参考。Objective To develop a surge response capacity index system for on-scene and in-hospital response of mass casualty incidents,to provide evaluation and training reference to disaster management.Methods By literature research,a draft of the index system was developed based on the CO-S-TR model.Delphi technique was used to consult 12 experts for 2 rounds.Analytic Hierarchy Process and average distribution method were used to calculate index weights.According to the determined index system,the evaluation checklist of surge capability was formulated,which was used for the evaluation of the medical staff in a disaster response tabletop exercise,and it was scored by three instructors independently.Results Response rate of the two round consultations were 100%;The experts’ authority coefficients were 0.85 and 0.88;Kendall’coefficients of concordance were 0.238 and 0.203respectively,which were statistically significant(P<0.001).The on-scene response index system comprised 3 firstlevel indexes,12 second-level indexes,30 third-level indexes,while the in-hospital index system contains 3 firstlevel indexes,12 second-level indexes,38 third-level indexes.Consistence between the evaluators of the checklist seven rounds tabletop exercises involving 157 medical staff were conducted,and the results showed good consistency of the checklist among the evaluators(P<0.001).Conclusion Systematic and scientific index systems of emergency response to mass casualty incidents in different stages were developed,which can provide reference to emergency response training,and be used to evaluate the surge capacity of health care system.

关 键 词：成批伤 过负荷能力 应急响应 德尔菲法 

分 类 号：R197.6[医药卫生—卫生事业管理]