基于价值流程图的急性心肌梗死患者直接经皮冠状动脉介入治疗流程的构建及应用  

Construction of Primary Percutaneous Coronary Intervention process for patients with acute myocardial infarction based on Value Stream Map and its application effect

作　　者：叶丽霞 李琴[1] 周虹[1] YE Lixia;LI Qin;ZHOU Hong(Emergency Department,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,310000,China)

机构地区：[1]浙江大学医学院附属第一医院急诊科,杭州市310000

出　　处：《中国护理管理》2023年第12期1801-1806,共6页Chinese Nursing Management

基　　金：浙江省医药卫生科技计划项目(2022KY775)。

摘　　要：目的:基于价值流程图构建急性心肌梗死患者直接经皮冠状动脉介入治疗流程,并评价其在急性心肌梗死患者救治中的应用效果,以期为提高急性心肌梗死患者的救治效率提供借鉴。方法:将急诊行直接经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者按住院时间顺序分为对照组32例和观察组30例,对照组实施常规治疗,观察组实施基于价值流程图的直接经皮冠状动脉介入治疗流程。比较两组流程时间、重要救治节点时间和救治效果。结果:实施后,观察组非增值时间和总流程时间较对照组缩短,入医院大门至球囊扩张时间、院内首份心电图获得时间、肌钙蛋白报告时间、导管室启动时间较对照组缩短,治愈出院率高于对照组,差异均具有统计学意义(P<0.05)。结论:实施基于价值流程图的急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗流程可促进患者的高效救治。Objective:To construct a Primary Percutaneous Coronary Intervention process for patients with acute myocardial infarction based on Value Stream Map and to evaluate its application effect,in order to provide reference for improving the treatment efficiency of patients with acute myocardial infarction.Methods:According to the length of hospital stay,patients with acute ST-segment Elevation Myocardial Infarction who underwent Primary Percutaneous Coronary Intervention were divided into control group(n=32)and observation group(n=30).The control group was treated with routine treatment,and the observation group was treated with Primary Percutaneous Coronary Intervention process based on Value Stream Map.The process time,important treatment node time and treatment effect of the two groups were compared.Results:After implementation,the non-value-added time and total process time of the observation group were significantly shortened(P<0.05).The time from admission to balloon dilatation,the acquisition time to obtain the first ECG,the time of troponin reporting and the start-up time of the catheterization room of the observation group were significantly shortened(P<0.05).The cure and discharge rate was higher than that of the control group(P<0.05).Conclusion:The implementation of Primary Percutaneous Coronary Intervention process for patients with acute ST-segment Elevation Myocardial Infarction based on Value Stream Map can promote the efficiency of treatment.

关 键 词：价值流程图 精益医疗 急性ST段抬高型心肌梗死 流程优化 急救医疗服务 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]