急性后循环缺血性脑卒中患者早期识别预检分诊评估工具的构建  

Construction of emergency triage assessment tool for early identification of acute posterior circulation ischemic stroke

作　　者：罗翠芳 史蕾[1] 杜仲年[2] 陈思宇 傅贤 LUO Cuifang;SHI Lei;DU Zhongnian;CHEN Siyu;FU Xian(School of Nursing,Southern Medical University,Guangzhou 510515,China;Dept.of Emergency,Shenzhen Songgang People’s Hospital,Shenzhen 518100,China;Dept.of Neurology,Shenzhen Songgang People’s Hospital,Shenzhen 518100,China)

机构地区：[1]南方医科大学护理学院,广东广州510515 [2]深圳市宝安区松岗人民医院急诊医学科,广东深圳518100 [3]深圳市宝安区松岗人民医院神经内科,广东深圳518100

出　　处：《护理学报》2025年第8期74-78,共5页Journal of Nursing(China)

基　　金：深圳市基础研究面上项目(20240809164314002号)。

摘　　要：目的构建适合于急诊预检分诊环境下使用的评估工具,帮助护士早期识别急性后循环缺血性脑卒中患者。方法通过文献研究,运用德尔菲法对23名涵盖急诊护理管理、卒中中心领导、神经内科临床及护理领域的专家展开2轮函询。结果2轮函询专家有效回收率为92%、100%,专家权威系数分别是0.959、0.970,肯德尔协调系数分别是0.230、0.341(P<0.001)。最终形成的急性后循环缺血性卒中分诊评估工具分为2个维度、8个评估项目、3类分诊护士指引、1个进入卒中中心标准。结论急性后循环缺血性脑卒中预检分诊评估工具构建合理,研究方法科学,研究结果可靠,为急诊患者分诊流程优化、效率提高提供了有力依据。助推急诊护理专科能力进步。Objective To construct an assessment tool specifically designed for emergency settings to help identify acute posterior-circulation ischemic stroke(APCIS)patients during initial assessment.Methods Through literature review,the Delphi method was used to conduct two rounds of consultation with 23 experts in the field of emergency nursing management,stroke center,and neurology and nursing.Results The effective recovery rates of the two rounds of consultation were 92%and 100%,the expert authority coefficients 0.959 and 0.970,and the Kendall’s concordance coefficients 0.230 and 0.341,respectively(P<0.001).The final triage assessment tool for APCIS comprised two dimensions with eight assessment items,incorporated three triage nurse decision pathways,and established one stroke center admission criterion.Conclusion The constructed assessment tool for pre-examination and triage of APCIS is scientific and rigorous,and this reliable instrument provides an evidence-base foundation for optimizing emergency triage workflows and improving efficiency,while advancing specialized emergency nursing competencies.

关 键 词：后循环缺血 脑卒中 早期识别 预检分诊 

分 类 号：R473.54[医药卫生—护理学]