医护人员对急性缺血性卒中院内救治静脉溶栓流程优化的质性研究

目的探讨急性缺血性卒中静脉溶栓流程中可优化环节,为救治流程进一步优化提供依据。方法 2016年5-6月,采用目的抽样方法选取上海市某三级甲等医院12名参与急性缺血性卒中院内救治医务人员为研究对象,运用半结构式深入访谈法对其进行访谈,通过笔记及录音采集数据,应用Colaizzi内容分析法进行资料分析。结果医护人员对急性缺血性卒中院内救治静脉溶栓流程的体验包括5个主题:(1)目前救治流程基本合理;(2)对卒中急救护士配置的需求;(3)对信息化平台支持的需求;(4)患者和家属医疗决策时间延迟;(5)对多学科合作密切性加强的需求。结论有必要将溶栓地点前移至CT室并配置卒中急救护士岗位,加快建设急性缺血性卒中救治信息平台,开展院内多元化病情告知方式,加强多学科合作密切性,进一步缩短急性缺血性卒中院内救治时间。

Optimization of in Hospital Intravenous Thrombolytic Process among Patients with Acute Ische-mic Stroke:A Qualitative Study

Objective To explore the optimization of in hospital intravenous thrombolytic process among patients with acute ischemic stroke,in order to provide reference for further optimization of the treatment process.Methods By using purposive sampling method,12 cases of medical staff from Changhai Hospital of Second Military Medical University were selected and interviewed by using phenomenological approach, and Colaizzi data analysis principles were used to analyze and refine topic.Results Five themes were ex-tracted :the current treatment process was reasonable;the demand for the allocation of stroke emergency nurses;the demand for information platform construction;patient and family medical decision-making time delay;the need for enhance interdisciplinary cooperation.Conclusions It is necessary to move the thrombo-lytic site to the CT room,and establish stroke emergency nurses post,and learn from the successful experi-ences of chest pain center to accelerate the construction of stroke information platform ,and carry out a va-riety of hospital disease informed ways,and strengthen the multidisciplinary cooperation,so that further shorten in-hospital time of acute ischemia stroke.