急诊分级转运方案实施对急性卒中患者院内转运安全和质量的影响

Effect of emergency grading and transshipment program on the safety and quality of in-hospital transport in patients with acute stroke

中文关键词: 急性卒中  分级转运  优化流程  安全  质量  满意度

英文关键词: Acute stroke  Hierarchical transport  Optimization process  Safety  Quality  Satisfaction

中文摘要:

      目的：探讨《急诊危重症患者院内转运共识》为原则的分级转运方案对急诊科急性卒中患者院内安全转运质量的影响结果。方法：选取本院急诊科近三年来院内转运交接的急性卒中患者88例作为研究对象，其中2017年1月至2017年12月的32例急性卒中患者作为对照组，2018年1月至2019年7月56例急性卒中患者作为观察组。对照组执行常规转运，观察组执行“降阶梯预案、充分评估、优化分级、最佳路径、动态评估”为原则的分级转运方案。对比两组患者院内转运安全和质量评价指标。结果：两组患者均得到安全、快速的转运，经过积极有效的救护，患者病情均有明显好转。观察组接诊至确诊时间、确诊至接受急救治疗时间及院内转运交接平均耗时均明显短于对照组；观察组转运质控考核得分明显高于对照组，观察组患者家属对急诊护理服务满意度及交接科室满意度均明显高于对照组，差异均有统计学意义（P＜0.05）。结论：急性卒中患者院内转运流程规范并优化后，患者院内转运安全性和转运质量明显提高，患者得到了安全、快速的转运和积极有效的救护，患者抢救成功率和患者家属及相关科室对急诊护理服务满意度明显提高。

英文摘要:

      Objective: To investigate the effect of the principled stratified transshipment program on the quality of in-hospital safety of patients with acute stroke in emergency department. Methods: Eighty-eight patients with acute stroke who were transferred to the hospital in the emergency department of our hospital in the past three years were selected as subjects. Among them, 32 patients with acute stroke from January 2017 to December 2017 were used as control group, from January 20 to July 2019. Fifty-six patients with acute stroke were included as observation groups. The control group performed routine transshipment, and the observation group implemented a hierarchical transshipment plan based on the principle of “downgrading plan, full evaluation, optimized grading, optimal path, and dynamic evaluation”. The in-hospital transport safety and quality evaluation indicators of the two groups were compared. Results: Both groups of patients were safely and quickly transported. After active and effective rescue, the patients' condition improved significantly. The average time taken from the observation group to the time of diagnosis, the time from diagnosis to the first aid treatment and the transfer of the hospital were significantly shorter than that of the control group. The scores of the transport quality control assessment of the observation group were significantly higher than those of the control group. The family members of the observation group were satisfied with the emergency care service. The satisfaction degree of the degree and delivery department was significantly higher than that of the control group, and the difference was statistically significant (P＜0.05). Conclusion: After the in-hospital transfer process of acute stroke patients is standardized and optimized, the patient's in-hospital transport safety and transfer quality are significantly improved. Patients are safely and quickly transported and actively and effectively rescued. The patient's rescue success rate and patient's family and related departments' emergency care services. Satisfaction is significantly improved.