基于业务再造理论的急性大咯血院内急救护理流程的应用效果研究  

Effect of emergency nursing process in hospital for acute massive hemoptysis based on business reengineering theory

作　　者：何龑 毛燕君 张峥 杨君[4] 闵思文 He Yan;Mao Yanjun;Zhang Zheng;Yang Jun;Min Siwen(Department of Respiration,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China;Department of Nursing,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China;Department of Radiology,Shanghai Pulmonary Hospital Affilated to Tongji University,Shanghai 200433,China;Department of Emergency,Shanghai Pulmonary Hospital Affilated to Tongji University,Shanghai 200433,China;Department of Respiratory and Critical Care Medicine,Shanghai Pulmonary Hospital Affilated to Tongji University,Shanghai 200433,China)

机构地区：[1]同济大学附属上海市肺科医院呼吸科,上海200433 [2]同济大学附属上海市肺科医院护理部,上海200433 [3]同济大学附属上海市肺科医院影像科,上海200433 [4]同济大学附属上海市肺科医院急诊科,上海200433 [5]同济大学附属上海市肺科医院呼吸与危重症医学科,上海200433

出　　处：《中国实用护理杂志》2023年第2期81-87,共7页Chinese Journal of Practical Nursing

基　　金：上海市卫生健康委员会科研项目(20214Y0258);上海市肺科医院护理精英人才库项目(HL-B1)。

摘　　要：目的基于业务再造理论构建急性大咯血院内急救护理流程,探讨其应用效果。方法采用类试验研究方法按住院顺序,选择2020年1—6月于同济大学附属上海市肺科医院急诊入院的200例急性大咯血患者为对照组,采用原救治流程;选择2020年7—12月于该医院急诊入院的200例患者为试验组,应用再造后的急性大咯血院内急救护理流程。2组均使用急性大咯血院内救治时间记录表记录各子流程所耗时间,通过电子病例收集患者临床结局。比较2组患者入院后院内救治流程各环节耗时、救治效率、患者结局。结果最终对照组和试验组各纳入192例。试验组入院至静脉使用止血药时间和入院至经血管内治疗血管穿刺时间的中位数分别为21.50(20.00,22.50)、82.50(79.50,84.50)min,低于对照组的40.87(37.06,44.43)、135.50(123.50,147.00)min,2组比较差异均有统计学意义(Z=-16.84、16.63,均P<0.01)。试验组急性大咯血所致窒息发生率为4.2%(8/192),低于对照组的13.0%(25/192),2组比较差异有统计学意义(χ2=9.58,P<0.01)。结论急性大咯血院内急救护理流程有效缩短了急性大咯血院内救治时间,进一步促进了急性大咯血院内救治多环节无缝衔接,提高了急性大咯血患者院内救治效率。Objective Based on the business reengineering theory,to construct the emergency nursing process of acute massive hemoptysis in hospital and explore the effect of it.Methods According to the order of hospitalization,200 patients with acute massive hemoptysis admitted to the emergency department in Shanghai Pulmonary Hospital Affilated to Tongji University from January to June in 2020 were selected as the control group,and the original treatment process was adopted.Two hundred patients admitted to the emergency department of this hospital from July to December in 2020 were selected as the experimental group,and the reconstructed in-hospital emergency nursing process for acute massive hemoptysis was applied.In both groups,the researchers recorded the time spent in each sub-process by using the in-hospital treatment time record of acute massive hemoptysis and collected the clinical outcomes of patients through electronic cases.The time-consuming,treatment efficiency and patient outcome of each link of the treatment process in the backyard of the two groups were compared.Results Finally,192 patients were enrolled in the control group and the experimental group.The median time from admission to intravenous use of hemostatic drugs and from admission to endovascular treatment in the experimental group were 21.50(20.00,22.50)and 82.50(79.50,84.50)min,which were lower than those in the control group which spent 40.87(37.06,44.43)and 135.50(123.50,147.00)min,and the differences between the two groups were statistically significant(Z=-16.84,16.63,both P<0.01).The incidence of asphyxia caused by acute massive hemoptysis in the experimental group was 4.2%(8/192),which was lower than that in the control group,which was 13.0%(25/192).There was a statistically significant difference in the incidence of asphyxia between the two groups(χ2=9.58,P<0.01).Conclusions The emergency nursing process of acute massive hemoptysis effectively shortens the time of in-hospital treatment of acute massive hemoptysis,further promotes the seamless

关 键 词：大咯血 介入治疗 流程再造 应用效果 

分 类 号：R472.2[医药卫生—急诊医学]