智能化急诊预检分诊系统对急诊预检分诊质量的影响

目的：探讨智能化急诊预检分诊系统对急诊预检分诊质量的影响。方法：选取2019年6月1日～2020年6月30日418例急诊就诊患者为研究对象。将2019年6月1日～12月31日就诊的209例患者分为对照组,实施常规急诊预见分诊流程;将2020年1月1日～6月30日就诊的209例患者分为观察组,在对照组基础上实施智能化急诊预检分诊系统进行急诊分诊。比较两组分诊质量、患者等候时间及患者或家属满意度。结果：观察组分诊时间、期望分诊时间、与期望分诊时间差均短于对照组(P<0.01);观察组危重患者分诊检出率、分诊准确率均高于对照组(P<0.05,P<0.01),候诊意外发生率低于对照组(P<0.05);观察组患者或家属急诊就诊次序、信息沟通、就诊优先性、分诊准确性评分均高于对照组(P<0.01)。结论：门诊预检分诊采用智能化急诊预检分诊系统管理,有助于提高分诊准确率,缩短患者等待时间,预防候诊意外发生,提高患者及家属满意度。     

网络智能信息化预检分诊系统在急诊中的应用

目的:探讨网络智能信息化预检分诊系统在急诊中的应用方法及效果。方法:随机选取2014年1月1日~2016年12月31日急诊就诊患者500例为对照组,采用传统的急诊预检分诊方法;随机选取2017年1月1日~2019年12月31日急诊就诊患者500例为观察组,采用网络智能信息化预检分诊系统进行预检分诊。比较两组分诊准确率、分诊所需时间及患者就医满意度。结果:两组分诊准确率、分诊所需时间、患者就医满意度比较差异有统计学意义(P<0.05,P<0.01)。结论:网络智能信息化预检分诊系统可有效提高患者分诊准确率,缩短分诊时间,提高就医满意度。     

急诊预检分诊信息系统在脑中风患者诊治中的应用效果

目的探讨一体化急诊护理体系中预检分诊系统的建设对脑中风患者诊治效果的影响。方法选取2017年6~12月该院急诊科收治的脑中风患者118例作为对照组,采取传统急诊就诊模式诊治;2018年1~7月该院急诊科收治的脑中风患者121例作为研究组,采取急诊预检分诊系统模式诊治。对比两组患者分诊准确率、诊治等待时间、偏瘫发生率及患者护理满意度情况。结果研究组患者的分诊准确率及护理满意度比对照组患者高,偏瘫发生率较低,研究组患者的等待时间及诊治时间明显短于对照组患者,差异有统计学意义(P<0.05)。结论一体化急诊护理体系中预检分诊系统的建设可以有效提高患者分诊准确率及护理满意度,大大缩短患者就诊等待时间及诊治时间,改善脑中风患者的预后。     

信息化儿童预检分诊系统在儿童急诊分诊管理中的应用研究

目的:探讨信息化儿童预检分诊系统在儿科急诊分诊管理中的应用效果.方法:采取便利抽样法选取2016年10月—2016年12月(信息化儿童预检分诊系统实施前)急诊患儿450例作为对照组,选取2018年10月—2018年12月(信息化儿童预检分诊系统实施及使用成熟后)急诊患儿450例作为观察组.比较两组患儿分诊准确率、分诊登记时长、患儿家属对分诊的满意度.结果:观察组患儿分诊准确率为98.4％,高于对照组的91.3％(P<0.01);观察组患儿分诊登记时长为(42.69±11.32)s,短于对照组的(95.87±67.22)s(P<0.01);观察组患儿家属对分诊护士服务态度、管理候诊秩序的满意度均高于对照组(P<0.05).结论:信息化儿童预检分诊系统的设计与应用,实现了儿童急诊分诊信息化和智能化,提高了儿童急诊分诊的质量和效率,在保证急诊患儿生命安全的同时,提高了患儿及家属对分诊的满意度.     

急诊预检分诊评分系统在儿科急诊患者病情评估中的应用价值

目的:探讨急诊预检分诊评分系统应用于儿科急诊患者病情评估中的应用价值。方法:选取2019年9月在无锡市儿童医院儿科急诊就诊患儿1 019例作为研究对象,采用急诊预检分诊评分系统对患儿的生命体征及症状进行评价,针对不同改良儿童早期预警评分(MPEWS)对患儿的去向进行分析,同时分析MPEWS评分与患儿病情严重程度及预后情...     

急诊预检分诊系统的应用及效果评价

目的:采用急诊预检分诊系统对急诊患者进行预检分诊并进行效果评价。方法:采用方便抽样法抽取2012年1、4、8月每月100名共计300名来我院急诊就诊患者作为对照组,同样方法抽取2013年1、4、8月间来我院急诊就诊的300例患者作为实验组,实验组采用急诊预检分诊系统对患者进行预检分诊。对两组危重症患者的等候时间、意外发生率、患者和医护人员的满意度进行比较。结果:实验组危重患者就诊等候时间明显缩短,急诊患者或家属满意度较对照组高,差异有统计学意义(P0.05);实验组危重患者在候诊期间无一发生意外;医护人员对急诊预检分诊系统满意度较高。结论:采用急诊预检分诊系统能改善急诊就诊环境,缩短危重患者等候时间,降低危重患者在候诊过程中的意外发生率,使急诊就诊患者的满意度提高,急诊医护人员对此系统也有较高的评价,可在临床推广应用。     

急诊预检分诊系统概况与进展

急诊预检是对急诊患者进行快速分类以确定治疗或进一步处理的优先次序过程.预检工作直接关系到急诊服务质量、患者救治效果和患者对医院的满意度.     

急诊预检分诊评分系统在急诊住院患者预后评估中的应用

目的:评估急诊预检分诊评分(EDTS)在急诊入院患者预后预测中的价值。方法:回顾性从2018-11-01—2018-12-31期间于武汉大学人民医院急诊入院的患者中筛选符合标准的病例,收集每名患者信息,分别计算EDTS分值然后进行统计分析。结果:本研究纳入急诊住院患者共584例,其中男363例(62.16%),女221例(37.84%),最终好转出院患者528例(90.41%),死亡患者56例(9.59%)。死亡患者入院EDTS分值高于好转出院患者(14.93±7.66vs.23.53±11.47,P0.01),多因素分析显示EDTS为患者预后的独立预测因素(OR=1.103,P0.001;EDTS评分对患者预后预测ROC曲线下面积为0.730(95%CI:0.658～0.801,P0.01)。结论:EDTS评分对急诊入院患者预后具有较好的预测效果,具备作为急诊预检分诊标准的基础。     

如何提高急诊预检分诊的质量

随着现代医学的飞速发展,急诊科已成为医院一个重要医疗部门,是救治各种急诊重危伤病员的重要场所.如何提高急诊抢救及护理的质量,预检分诊是关健.其重要性在于正确的预检分诊可使重危的伤病员及时得到迅速、正确、有效的诊断、抢救治疗及护理.反之,则势必会带来各科之间的相互会诊、协调,从客观上拖延抢救时间,从而失去抢救伤病员生命的宝贵时机。因此,急诊工作中的预检分诊应注意以下几个方面的问题。     

持续护理质量改进模式在门诊预检分诊中的应用效果

目的探讨持续护理质量改进(CQI)模式在门诊预检分诊中的应用效果。方法选取本院门诊部2020年1月至2020年6月接诊的200例患者作为对照组,2020年7月至2020年12月接诊的200例患者作为观察组;每组各配置20名护理人员。对照组给予常规门诊预检分诊,观察组给予CQI模式门诊预检分诊。比较两组的干预效果。结果观察组的分诊评估时间、分诊挂号时间及危重患者等候时间均短于对照组,且分诊准确率高于对照组(P<0.05)。观察组护理人员对患者依从性、候诊有序性、分诊正确性、就诊优先性的满意度评分均高于对照组(P<0.05)。观察组患者对候诊环境、预检服务、等候时间、就诊次序、信息沟通的满意度评分均高于对照组(P<0.05)。结论 CQI模式应用于门诊预检分诊中,可有效缩短患者耗时,提高分诊准确率及护理满意度。     

PQRST联合儿童早期预警评分对急诊患儿预检分诊效率及护理满意度的影响

[目的]探讨PQRST联合儿童早期预警评分对急诊患儿预检分诊效率及护理满意度的影响。[方法]将2600例急诊患儿按入院顺序分为对照组、观察组,每组1300例。对照组采用常规预检分诊模式,观察组采用PQRST联合儿童早期预警评分,比较两组预检分诊效率及护理满意度。[结果]观察组预检分诊时间短于对照组(P<0.01),分诊准确率高于对照组(P<0.01);护理满意度高于对照组(P<0.01)。[结论]PQRST联合儿童早期预警评分应用于急诊患儿预检分诊中能提高预检分诊效率,提升护理满意度。     

智能急诊分诊诊断治疗系统的研发与应用

目的 探讨智能急诊分诊诊断治疗系统在急诊科分诊中的应用效果。方法 采取便利抽样的方法,选择某三级甲等医院400例急诊科就诊患者为研究对象,根据入院时间先后顺序将其分为对照组和观察组各200例,对照组采用常规人工预检分诊,观察组应用智能急诊分诊诊断治疗系统预检分诊,比较2组患者病情资料收集时间、分诊时间、过度分诊率及患者对护士分诊工作的满意度。结果 观察组的病情资料收集时间、分诊时间均比对照组短,差异有统计学意义（P<0.05）;观察组护士过度分诊率比对照组低,差异有统计学意义（P<0.05）;同时,观察组患者对护士分诊工作表示满意的有196例,对照组中40例患者认为分诊较慢、流程繁琐等原因,表示不满意,2组满意度的比较差异有统计学意义（P<0.05）。结论 在急诊科,结合应用智能急诊分诊诊断治疗系统,优化急诊分诊流程,快速对患者病情进行分类和归纳,减少了分诊时间,保障护士的分诊效率,从而进一步保障患者安全,提高患者的满意度。     

主题日服务在优质护理工作中的应用研究

【】：目的 探讨主题日服务在优质护理工作中的应用价值及效果。方法：选择2011年10月～2012年3月收治泌尿外科病房的患者100例为试验组,按卫生部优质护理要求执行,并提供主题日服务;与2011年4月～2011年9月收治的100例按卫生部优质护理要求进行护理的患者采用前后对照研究方法,比较该病区两组住院患者满意度、医生对护士工作满意度、护士对自身工作满意度情况。 结果：住院患者满意度、医生对护士工作满意度、护士对自身工作满意度这三方面,两组的差异均有统计学意义(P<0.05)。 结论：开展“主题日服务”对提高护理服务满意度效果明显,减少了护患纠纷的发生,提高了护理服务质量,延伸了优质护理内涵。     

儿童急诊分诊信息系统的创建与应用研究

目的:创建基于五级预检分诊标准的儿童急诊分诊信息系统,并探讨其应用效果。方法:将2017年3月—2017年5月在医院急诊科接受治疗的10704例儿童设为对照组,以传统的“一看、二问、三查”分诊法为主;将2019年6月—2019年8月在医院急诊科接受治疗的10366例儿童设为试验组,采用基于五级预检分诊标准的急诊分诊信息系统进行分诊。比较两组就诊儿童分诊时间、分诊一致性、就诊儿童家属的满意度、医护人员的满意度。结果:对比医生和护士分诊级别,对照组患儿的Kappa值是0.58,试验组达到0.98;试验组就诊儿童的分诊时间明显短于对照组(P<0.01);在医护人员满意度、就诊儿童家属满意度方面,试验组明显高于对照组(P<0.01)。结论:基于五级预检分诊标准的儿童急诊分诊信息系统有利于减少急诊分诊时间,确保分诊有效性、准确性,明显提升就诊儿童家属、医护人员的满意度。     

Implementation of Prehospital Dispatch Protocols That Triage Low-acuity Patients to Advice-line Nurses

Abstract

Introduction. Although EMS agencies have been designed to efficiently provide medical assistance to individuals, the overuse of 9-1-1 as an alternative to primary medical care has resulted in the need for new methods to respond to this increasing demand. Our study analyzes the efficacy of classifying specific low-acuity calls that can be transferred to an advice-line nurse for further medical instruction. The objectives of our study were to analyze the impact of implementing this protocol and resultant patient feedback regarding the transfer to an advice-line nurse. Methods. We collected data for retrospective review from April 2011 to April 2012 from a single municipal EMS agency with an average annual call volume of approximately 90,000. Medical Priority Dispatch System response codes were assigned to calls based on patient acuity. Patients classified under Omega response codes were assessed for eligibility of transfer to nurse advice lines. Exclusion criteria included the following: if the call was placed by a third-party caller; if the patient refused to be transferred to the advice-line nurse; anytime the MPDS system was not used; if the patient was referred from a skilled nursing facility, school, or university nursing office, or physician's office. Telephone surveys were conducted for those patients who spoke to an advice-line nurse and did not receive an ambulance response 24 hours after calling 9-1-1 to obtain patient feedback. Results. The database included 1660 patients initially classified as Omega and eligible for transfer to an advice-line nurse. After applying the exclusion criteria, 329 (19.8%) patients were ultimately transferred to an advice-line nurse and 204 (12.3%) received no ambulance response. Of those patients who were not transported by ambulance 118 (57.8%), patients completed telephone follow-up, with 104 (88.1%) reporting the nontransport option met their health-care needs and 108 (91.5%) responding they would accept the transfer again for a similar complaint. Conclusion. We identified an average of two patients per day as eligible for transfer to the nurse advice line, with less than one patient successfully completing the Omega protocol per day. While impact was limited, there was a decrease in ambulance response.     

首因效应提高患者对急诊科检诊分诊护士满意率探索

目的：探讨首因效应提高急诊患者对检诊分诊护士满意率的效果。方法：2013-01-2013-02急诊科对分诊检诊护士实施首因效应培训,采用自制调查表和本院分诊护士绩效考核表,对比分析2013-03-2013-05和2012-03-2012-05,急诊分诊检诊护士在实施前后分诊准确率、患者满意率、患者投诉率和绩效考核成绩。结果：实施首因效应实施前后分诊准确率、患者满意率、分诊护士投诉率和分诊护士绩效考核成绩比较,差异有统计学意义（P〈0.05）。结论：首因效应可以显著提高急诊护士分诊准确率、急诊患者对检诊分诊护士的满意率,提高绩效考核成绩,同时降低患者的投诉率。     

The influence of patient acuity on satisfaction with emergency care: perspectives of family, friends and carers

Aims and objectives. To investigate the factors that influence satisfaction with emergency care among individuals accompanying patients to the emergency department and explore agreement between the triage nurse and accompanying person regarding urgency. Background. Many patients seeking treatment in hospital are escorted by an accompanying person, who may be a friend, family member or carer. Several factors influence patient satisfaction with emergency care, including waiting time and time to treatment. It is also influenced by provision of information and interpersonal relations between staff and patients. Research on satisfaction has focused on the patient perspective; however, individuals who accompany patients are potential consumers. Knowledge about the ways accompanying persons perceive the patient's medical condition and level of urgency will identify areas for improved patient outcomes. Design and methods. A prospective cross‐sectional survey with a consecutive sample (n = 128 response rate 83·7%) was undertaken. Data were collected in an Australian metropolitan teaching hospital with about 32,000 visits to the emergency department each year. The Consumer Emergency Satisfaction Scale was used to measure satisfaction with nursing care. Results. Significant differences in perceptions of patient urgency between accompanying persons and nurses were found. Those people accompanying patients of a higher urgency were significantly more satisfied than those accompanying patients of a lower urgency. These results were independent of real waiting time or the accompanying person's knowledge of the patients’ triage status. In addition, older accompanying persons were more satisfied with emergency care than younger accompanying persons. Discussion. Little attention has been paid to the social interactions that occur between nurses and patients at triage and the ways in which these interactions might impact satisfaction with emergency care. Relevance to clinical practice. Good interpersonal relationships can positively influence satisfaction with the emergency visit. This relationship can contribute to improved patient care and health outcomes.     

Prehospital Trauma Triage Decision-making: A Model of What Happens between the 9-1-1 Call and the Hospital

We describe the decision-making process used by emergency medical services (EMS) providers in order to understand how 1) injured patients are evaluated in the prehospital setting; 2) field triage criteria are applied in-practice; and 3) selection of a destination hospital is determined. We conducted separate focus groups with advanced and basic life support providers from rural and urban/suburban regions. Four exploratory focus groups were conducted to identify overarching themes and five additional confirmatory focus groups were conducted to verify initial focus group findings and provide additional detail regarding trauma triage decision-making and application of field triage criteria. All focus groups were conducted by a public health researcher with formal training in qualitative research. A standardized question guide was used to facilitate discussion at all focus groups. All focus groups were audio-recorded and transcribed. Responses were coded and categorized into larger domains to describe how EMS providers approach trauma triage and apply the Field Triage Decision Scheme. We conducted 9 focus groups with 50 EMS providers. Participants highlighted that trauma triage is complex and there is often limited time to make destination decisions. Four overarching domains were identified within the context of trauma triage decision-making: 1) initial assessment; 2) importance of speed versus accuracy; 3) usability of current field triage criteria; and 4) consideration of patient and emergency care system-level factors. Field triage is a complex decision-making process which involves consideration of many patient and system-level factors. The decision model presented in this study suggests that EMS providers place significant emphasis on speed of decisions, relying on initial impressions and immediately observable information, rather than precise measurement of vital signs or systematic application of field triage criteria.