驾驶舱资源管理模式在严重创伤患者急诊救治中的应用及效果评价  

Application and effect evaluation of cockpit resource management model in emergency treatment of severe trauma patients

作　　者：计可欣 叶荣华[1] 叶丽霞 徐莉[1] 章烨菲 周虹[1] JI Kexin;YE Ronghua;YE Lixia;XU Li;ZHANG Yefei;ZHOU Hong(Nursing Department,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,310000,China;不详)

机构地区：[1]浙江大学医学院附属第一医院护理部,杭州市310000

出　　处：《中华急危重症护理杂志》2025年第4期421-427,共7页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药卫生科技计划项目(2022KY775)。

摘　　要：目的探讨驾驶舱资源管理模式在严重创伤患者急诊救治中的应用效果。方法基于驾驶舱资源管理理念构建严重创伤患者的急诊救治模式,包括创伤救治团队的组建、信息系统的优化、环境分区改造、物品的目视化管理及严重创伤患者救治流程单的制订。采用方便抽样法,选取2023年1月—5月、8月—12月杭州市某三级甲等医院急诊科收治的119例严重创伤患者作为研究对象,试验组(n=61)采用基于驾驶舱资源管理理念构建的严重创伤救治模式,对照组(n=58)采用常规救治模式。比较两组救治过程关键指标、医疗资源利用情况及救治效果。结果试验组5 min静脉或骨通路开通率、留观至气管插管时间有所改善,但与对照组比较差异无统计学意义(P>0.05)。试验组创伤重点超声评估达标率及分诊准确率明显优于对照组(P<0.05),试验组留观至急诊手术时间及抢救室停留时长明显短于对照组,治疗费用少于对照组(P<0.05)。试验组48 h转归及出院3个月自理能力明显优于对照组(P<0.05)。结论基于驾驶舱资源管理理念构建的严重创伤救治模式,加强了救治流程连续性及系统性,缩短了救治时间,患者救治效果及预后得到改善且节约了医疗资源。Objective To explore the effect of cockpit resource management model in emergency treatment of severe trauma patients.Methods We constructed the emergency treatment mode of severe trauma patients based on the concept of cockpit resource management,including the establishment of trauma rescue team,the optimization of intelligent system,the transformation of environmental zoning,the visual management of items,and the development of treatment process list of severe trauma patients.We used convenience sampling to select 119 cases of severe trauma patients admitted to the emergency department of a tertiary class A hospital in Hangzhou from January to May and from August to December 2023 as the study subjects.The experimental group(n=61)received the severe trauma treatment model constructed based on the concept of cockpit resource management,and the control group(n=58)received the conventional treatment model.The treatment process timeliness indexes,medical resource utilization and treatment effects were compared between the two groups.Results The venous or intraosseous opening rate within 5 min and the time of endotracheal intubation in experimental group were improved,but there was no significance compared with the control group(P>0.05).Focused assessment with sonography for trauma(Fast)compliance rate and triage accuracy rate of the experimental group were significantly better than control group(P<0.05),the time from admission to operation and the length of stay in the resuscitation room were significantly shorter than control group,and the treatment cost was less than the control group(P<0.05).48h outcome and self-care ability after 3 months in the experimental group were significantly better than the control group(P<0.05).Conclusion The use of cockpit resource management to severe trauma patients can strengthen the continuity and systematization of treatment,shorten the duration of treatment,improve the treatment effect and patient outcome,and save medical resources.

关 键 词：急诊室 医院 急诊急救 驾驶舱资源管理 严重创伤 救治模式 

分 类 号：R47[医药卫生—护理学]