预警分级管理在急诊危重症患者院内转运中的应用效果

目的 探讨预警分级管理在减少急诊危重症患者院内转运不良事件中的应用效果。方法 我科成立项目团队,明确急诊危重症患者院内转运质量改进目标,分析患者院内转运过程中存在的问题,从病情、设备、转运人员等方面建立预警分级管理,并应用在急诊危重症患者院内转运中,比较实施前(2017年6-12月)及实施后(2018年1-6月)患者院内转运时间及转运过程中不良事件发生情况。结果 实施后,急诊科患者转运至CT室、重症病房及手术室的时间均短于实施前(t=60.557,P<0.001;t=14.096,P<0.001;t=45.117,P<0.001);实施后转运期间不良安全事件发生率显著低于实施前(χ²＝58.699,P<0.001)。结论 预警分级管理能有效缩短院内转运时间,降低急诊危重症患者院内不良安全事件发生率,提高患者院内转运安全性。

Effects of early warning and grading management in intrahospital transport of critically ill patients

Objective To explore the effect of early warning and grading management on reducing the adverse events of intrahospital transport of critically ill patients. Methods A project team was set up to clarify the goal of improving the quality of in-hospital transport, and analyze the problems existed in the transport. The early warning and hierarchical management was establish from the aspects of patients′ condition, equipment and transport personnel and implemented. Time of transport and the occurrence of adverse events during the transport were compared before and after the implementation. Results The complications of intrahospital transport of criticallyill patients were significantly lower than that before implementation (χ²＝58.699,P<0.001). The time of transfer to the CT room, intensive care unit, and operating room was significantly shorter than that before implementation (t=60.557,P<0.001; t=14.096,P<0.001; t=45.117,P<0.001). Conclusion Early warning and grading management can effectively reduce the incidence of adverse events in hospital for critically ill patients and improve the efficiency and safety of their intrahospital transport.