早期改良預警預警評分在急診觀察室的應用與評價

奚建媛　蔡佩源　苗傲霜

[摘要] 目的 闡述急診觀察室施行早期改良預警評分的具體措施及應用價值，并對其效果進行評價。 方法 該次研究時間為2018年9月—2019年9月，方便抽選該院急診觀察室留觀患者285例作為研究對象，將其隨機分為兩組，對照組施以常規評估分流處理，觀察組施以早期改良預警評分，并結合評分結果進行有效分流，記錄各組患者待診用時，同時分析各組患者待診過程中出現意外情況的概率及病死率，評估各組患者就診過程中滿意情況。結果 觀察組患者待診用時（26.48±14.29）min明顯短于對照組，差異有統計學意義（P<0.05），另外，觀察組發生意外情況發生率、病死率均明顯低于對照組，差異有統計學意義（P<0.05）。觀察組患者對該次就診的服務態度滿意評分（18.45±1.04）分、分診合理滿意評分（17.95±1.15）分、環境滿意評分（18.69±0.98）分、總滿意評分（54.48±2.05）分均較對照組更高，差異有統計學意義（t=8.670、7.960、7.010、9.930，P<0.05）。結論 針對急診觀察室患者施以早期改良預警評分可更快速、合理地分析患者病情，及時予以分診，保障醫療資源的合理運用，且提高患者就診滿意度。

[關鍵詞] 早期改良預警;預警評分;急診觀察室;應用

[中圖分類號] R473 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1674-0742（2020）10（a）-0143-03

Application and Evaluation of Early Modified Early Warning Score in Emergency Observation Room

XI Jian-yuan， CAI Pei-yuan， MIAO Ao-shuang

Emergency Adult Observation Room， Wuxi People's Hospital， Nanjing Medical University， Wuxi， Jiangsu Province， 214023 China

[Abstract] Objective To describe the specific measures and application value of implementing early improved early warning scoring in emergency observation room， and to evaluate its effect. Methods The study period was from September 2018 to September 2019. 285 patients in the emergency observation room of the hospital were conveniently selected as the research objects， and they were randomly divided into two groups， the control group with routine assessment and triage processing. The observation group was given an early modified early warning score， combined with the score results for effective triage， recorded the waiting time of each group of patients， and analyzed the probability of unexpected situations and mortality during the waiting process of each group of patients， and evaluate the satisfaction of the patients in each group. Results The waiting time （26.48±14.29） min of patients in the observation group was significantly shorter than that in the control group，the difference was statistically significant（P<0.05）. In addition， the rate of accidents and mortality in the observation group were significantly lower than those in the control group，the difference was statistically significant（P<0.05）. The observation group's service attitude satisfaction score （18.45±1.04）points， triage rationality satisfaction score （17.95±1.15）points， environmental satisfaction score （18.69±0.98）points， and total satisfaction score （54.48±2.05）points were all higher than the control group，the difference was statistically significant（t=8.670，7.960，7.010，9.930，P<0.05）. Conclusion Applying early modified early warning scores to patients in the emergency observation room can analyze the patient's condition more quickly and rationally， promptly triage， ensure the rational use of medical resources， and improve patient satisfaction.

該次研究結果所示，觀察組患者在急診觀察室留置時間（26.48±14.29）min明顯短于對照組（t=17.140，P<0.05），且待診期間出現意外情況的概率4.20%相較對照組12.68%更低（χ2=6.640，P<0.05）。該研究結果與鄭錚[12]發表文章結果實驗組患者就診用時（28.46±5.24）min短于對照組（33.25±9.24）min（t=2.160，P<0.05），且實驗組患者出現不良情況的概率6.94%低于對照組52.17%（χ2=4.57，P<0.05）相一致。

綜上所述，針對急診觀察室患者施以早期改良預警評分可更快速、合理地分析患者病情，及時予以分診，保障醫療資源的合理運用，且提高患者就診滿意度。

[參考文獻]

[1] ?馮曉昉.改良早期預警評分對急診胸痛患者預檢分診的價值[J].貴州醫科大學學報，2019，44（8）：983-986.

[2] ?李香娥，屠偉芬，張彪.改良早期預警評分在急診搶救室患者分診中的可行性研究[J].中華現代護理雜志，2018，24（34）：4152-4155.

[3] ?韓鳳玉，閆鳳華，馬亮亮， 等.急診危重指數聯合改良早期預警評分在急診分診患者中的應用[J].齊魯護理雜志，2018， 24（14）：8-10.

[4] ?蹇英，朱雪鳳，王惠芬， 等.改良早期預警評分在兒童急診分診中的應用[J].中國急救復蘇與災害醫學雜志，2018，13（1）：97-98.

[5] ?劉海燕……