住院与非住院患者启动快速反应系统早期干预效果的回顾性分析  

Retrospective analysis of early intervention effect of initiating rapid response system in hospitalized and non-hospitalized patients

作　　者：闫丹萍 王钰炜[1] 武作家 叶晨儿 王飒[1] YAN Danping;WANG Yuwei;WU Zuojia;YE Chener;WANG Sa

机构地区：[1]浙江大学医学院附属第二医院急诊医学科,杭州市310009

出　　处：《中华急危重症护理杂志》2023年第1期66-70,共5页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：目的分析比较住院与非住院患者启动快速反应系统(rapid response systems,RRS)的早期干预效果。方法回顾性分析2016年1月—2021年12月浙江省某三级甲等医院启动RRS事件的患者资料,比较住院与非住院患者在启动时间、原因、人员和结局方面的区别。结果2016年—2021年共启动RRS 983例次,主要启动者是护士(94.80%),住院患者启动715例次(72.74%),非住院患者启动268例次(27.26%)。住院患者与非住院患者RRS启动后急救医疗小组(emergency medical team,MET)响应时间分别为3(2,4)min和2(1,3)min,就诊科室分别为外科(55.81%)和心血管内科(31.34%),启动RRS的主要原因分别为患者突发意识丧失(69.23%)和目击患者突然倒地(57.84%),92.77%需要进行现场干预。住院患者启动RRS时间分布较均匀,非住院患者的RRS启动时间集中分布在08:00—16:00。结论住院患者和非住院患者RRS启动后MET在5 min内到达,非住院患者在RRS启动时间、地点、原因及结局上与住院患者存在区别,需要关注非住院患者院内病情突发变化时RRS的启动,建议针对全院所有人员开展RRS相关培训和模拟演练。Objective To analyze and compare the difference of early intervention effect of initiating the rapid response system(RRS)between hospitalized and non-hospitalized patients.Methods The RRS events initiated in a tertiary class A hospital in Zhejiang Province from January 2016 to December 2021 were collected retrospectively.Differences of initiating time,reasons,personnel and patient outcome between hospitalized and nonhospitalized patients were analyzed.Results From 2016 to 2021,983 RRS events were initiated,including 715 inpatients(72.74%)and 268 non-hospitalized patients(27.26%).The main initiators of RRS were nurses(94.80%).The res-ponse time of the emergency medical team(MET)after the initiation of RRS was 3(2,4)minutes and 2(1,3)minutes for inpatients and non-hospitalized patients respectively.The visiting departments were surgery(55.81%)and cardiovascular medicine(31.34%).The main reasons for initiating RRS were sudden loss of consciousness(69.23%)and witnessing patients falling to the ground suddenly(57.84%).Most required on-site intervention(92.77%)after the initiation of RRS.There was no particularity in the distribution of RRS initiating time periods for inpatients,while the initiating time of RRS for non-hospitalized patients was from 08:00 to 16:00.Conclusion Under homogeneous management,both inpatients and non-hospitalized patients reached MET within 5 minutes after the initiation of RRS.Non-hospitalized patients differed from hospitalized patients in terms of time,place,reasons,and outcome.Attention needs to be paid to the initiation of RRS when the condition of nonhospitalized patients suddenly change in the hospital.It is recommended to carry out RRS-related training and simulation exercises for all personnel in the hospital.

关 键 词：快速反应系统 急救医疗服务 住院患者 非住院患者 护理管理研究 

分 类 号：R47[医药卫生—护理学]