危重症病人应用院内转运清单管理效果的Meta分析  

Management effect of hospital transport checklist for critically ill patients: a Meta-analysis

作　　者：李珂[1] 杨振楠 韩舒羽 张建霞[1] 张梦杰 LI Ke;YANG Zhennan;HAN Shuyu;ZHANG Jianxia;ZHANG Mengjie(Peking University First Hospital,Beijing100034 China)

机构地区：[1]北京大学第一医院,北京100034 [2]北京大学护理学院

出　　处：《循证护理》2022年第20期2736-2741,共6页Chinese Evidence-Based Nursing

基　　金：北京大学第一医院护理科研苗圃项目,编号:2021MP013。

摘　　要：目的:系统评价评价危重症病人院内转运清单的应用对预防不良事件的效果。方法:计算机检索the Cochrane Library、The Joanna Briggs Institute Library、PubMed、EMbase、CINAHL、Web of Science、中国知网、万方数据库、中国生物医学文献数据库、维普数据库、百度学术、谷歌学术中关于转运清单对改进危重症病人的干预性研究,检索时限为建库至2021年4月30日。由2名研究者按照纳入和排除标准筛选文献、提取资料、评价质量,然后用RevMan 5.4软件进行Meta分析或进行描述性分析。结果:共纳入13项干预性研究,涉及6 214例病人。Meta分析结果显示,危重症病人院内转运清单的应用能够降低总体不良事件发生率[OR=0.22,95%CI(0.15,0.33),P<0.000 01],提高危重症病人转运质量[SMD=1.92,95%CI(1.59,2.25),P<0.001],降低转运过程病情变化发生率[OR=0.40,95%CI(0.24,0.69),P=0.001],降低管路相关不良事件发生率[OR=0.21,95%CI(0.14,0.32),P<0.000 01],降低电子设备电量不足发生率[OR=0.17,95%CI(0.10,0.28),P<0.000 01],降低病人转运时间[MD=-7.30,95%CI(-10.20,-4.40),P<0.001],降低转运准备时间[MD=-7.06,95%CI(-8.47,-5.65),P<0.001],降低转运交接时间[MD=-9.12,95%CI(-13.99,-4.25),P<0.001]。结论:现有证据表明,危重症病人院内转运清单的应用能够有效预防不良事件发生,保障病人安全,建议临床实践中使用转运清单进行危重症病人的转运工作。Objective:To systematically evaluate the effect of hospital transport checklist on the prevention of adverse events in critically ill patients.Methods:Interventional studies on transport checklist for improving critically ill patients were searched from the Cochrane Library, the Joanna Briggs Institute Library, PubMed, EMbase, CINAHL,Web of Science, CNKI,WanFang Database, CBM,VIP,Baidu Academic and Google Academic.The retrieval time was from inception to April 30,2021.Two researchers screened the literature according to inclusion and exclusion criteria, extracted data and evaluated its quality, and then RevMan 5.4 software was used for Meta-analysis or descriptive analysis.Results:A total of 13 intervention studies were included, involving 6 214 patients.Meta-analysis results showed that critically ill patient inventory could reduce the overall incidence of adverse events [OR=0.22,95%CI(0.15,0.33),P<0.000 01],improve the transport score of critically ill patients[SMD=1.92,95%CI(1.59,2.25),P<0.001],decreased the incidence of disease deterioration during transport[OR=0.40,95%CI(0.24,0.69),P=0.001],decreased the incidence of pipe-related adverse events[OR=0.21,95%CI(0.14,0.32),P<0.000 01],reduced the incidence of transporter-related adverse events[OR=0.17,95%CI(0.10,0.28),P<0.000 01],reduce the transit time[MD=-7.30,95%CI(-10.20,-4.40),P<0.001],reduce the transit preparation time[MD=-7.06,95%CI(-8.47,-5.65),P<0.001],and reduce transit handover time[MD=-9.12,95%CI(-13.99,-4.25),P<0.001].Conclusion:Current evidence shows that hospital transport checklist intervention measures for critical ill patients can effectively prevent adverse events and ensure patient safety.It is recommended to use transport list in clinical practice to transfer critical ill patients.

关 键 词：危重症病人 转运清单 护理管理 META分析 系统评价 

分 类 号：R473[医药卫生—护理学]