標準化分級轉運方案對急診婦產科危急重癥患者院內轉運的影響

朱靜洋 張振宇

[摘要] 目的 觀察標準化分級轉運方案對急診婦產科危急重癥患者院內轉運的影響，旨在為標準化分級轉運方案的順利開展提供參考。 方法 采用整群抽樣法，回顧性分析2017年1—12月首都醫科大學附屬北京婦產醫院（以下簡稱“我院”）開展標準化實施前200例婦產科危重癥患者的臨床資料，作為對照組。同時，回顧性分析2018年1—12月我院開展標準化分級轉運方案后220例婦產科危重癥患者的臨床資料，作為觀察組。比較兩組患者在轉運途中不良事件的發生率、轉運完成時間及護理滿意度情況。 結果 觀察組轉運途中墜床、陰道出血、病情惡化及胎動異常發生率顯著低于對照組，差異有統計學意義（P < 0.05）。觀察組完成各項轉運時間顯著短于對照組，差異有統計學意義（P < 0.05）。觀察組護理滿意度顯著高于對照組，差異有統計學意義（P < 0.05）。 結論 標準化分級轉運方案的開展與實施，能夠降低急診科危重癥患者院內轉運的不良事件發生率，顯著縮短轉運時間，提高滿意度。建議在我院危重癥患者院內轉運中開展、實施，以提高轉運安全性。

[關鍵詞] 急診婦產科;危急重癥;標準化分級轉運;院內轉運

[中圖分類號] R472.2? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2020）07（c）-0185-04

Influence of standardized grading transfer program in department of emergency obstetrics and gynecology of critically ill patients on nosocomial transfer

ZHU Jingyang? ?ZHANG Zhenyu

Emergency Room， Beijing Obstetrics and Gynecology Hospital， Capital Medical University， Beijing? ?100026， China

[Abstract] Objective To observe the impact of standardized grading transfer program on nosocomial transfer of critically ill patients in department of emergency obstetrics and gynecology， and to provide a reference for the smooth implementation of standardized grading transfer program. Methods A cluster sampling method was used to retrospectively analyze the clinical data of 200 patients with critical gynecology and obstetrics in Beijing Obstetrics and Gynecology Hospital， Capital Medical University （hereinafter referred to as “our hospital”） from January to December 2017， as the control group. Retrospectively analyze the clinical data of 220 gynecological and critically ill patients after the standardized grading transfer program were carried out in our hospital from January to December 2018， as the observation group. The incidence of adverse events during the transfer， the time of completion of the transfer， and nursing satisfaction were compared between the two groups. Results The incidence of falling bed， vaginal bleeding， worsening of the condition and abnormal fetal movement during the transportation of the observation group were significantly lower than those of the control group， and the differences were statistically significant （P < 0.05）. The various time for completing the transfer in the observation group were significantly shorter than those in the control group， and the differences were statistically significant （P < 0.05）. The nursing satisfaction of the observation group was significantly higher than that of the control group， and the difference was statistically significant （P < 0.05）. Conclusion The development and implementation of the standardized grading transfer program can reduce the incidence of adverse events in nosocomial transport of critically ill patients in the department of emergency， significantly shorten the time of transport， and improve satisfaction. It is recommended to carry out and implement nosocomial transport of critically ill patients in our hospital to improve transport safety.

[Key words] Department of emergency obstetrics and gynecology; Critically ill; Standardized grading transfer; Nosocomial transfer

急診科是危急重癥患者入院首次接觸的場所，危重癥患者病情嚴重、多變且進展快、生命支持高度依賴等特點常需依靠院內轉運，明確診斷，在最短時間內接受專科治療，以達到理想預后[1-3]。危重癥患者常需在同一醫療單位不同醫療區域進行轉運，且院內轉運時患者常處于移動狀態，諸多因素均可導致病情突變[4-5]。因此，探尋合理高效的轉運方案，對保障轉運過程的安全、降低不良事件的發生率具有重要意義。標準化分級轉運是指在對患者生命特征、呼吸支持、意識狀態、主要臨床問題及轉運時間做出充分評估后，設計轉運方案、所需醫療設備、人員支持、各科室協調等方面均到位，旨在確保轉運過程安全、順利及應對突發事件的解決能力，并于結束后，對整個過程進行總結、評價、改進[6-7]。……