基于循证的标准化转运流程在神经外科危重症患者院内转运中的应用

目的探讨基于循证护理的标准化转运流程对神经外科危重症患者院内转运的影响。方法采用便利抽样法,选取2019年1—12月于湖北省荆州市中心医院神经外科监护室住院,且完成院内转运至CT检查区域的危重症患者600例。按入院时间分为观察组和对照组,每组各300例。观察组基于循证的标准化转运流程进行转运护理,对照组接受常规转运护理。比较两组转运不良事件发生率、患者家属满意度。结果观察组患者院内转运时突发抽搐或烦躁不安、血氧饱和度下降、血压/心率波动>20%、导管意外滑脱或堵塞、输液管脱管或堵塞、氧气不足、仪器设备故障、药品不足的发生率分别为1.3%(4/300)、7.0%(21/300)、4.7%(14/300)、0.3%(1/300)、8.3%(25/300)、0.3%(1/300)、0.7%(2/300)、0.3%(1/300),低于对照组的4.0%(12/300)、22.3%(67/300)、9.3%(28/300)、3.0%(9/300)、19.3%(58/300)、2.7%(8/300)、3.3%(10/300)、6.0%(18/300),差异均有统计学意义(P<0.05)。观察组患者家属整体满意率为91.9%(262/285),高于对照组的69.0%(187/271),差异有统计学意义(P<0.01)。结论实施基于循证的标准化转运流程能有效降低神经外科危重症患者转运不良事件的发生率,提高患者家属满意度。

Application of evidence-based standardized transfer process in hospital transportation of critically ill patients in neurosurgery department

Objective To explore the effect of the evidence-based nursing standardized transfer process on the hospital transfer of critically ill patients in neurosurgery department.Methods From January to December 2019,convenience sampling was used to select 600 critically ill patients who were hospitalized in the Neurosurgery Intensive Care Unit of Jingzhou Central Hospital in Hubei Province and were transferred to the computed tomography(CT)examination area in the hospital.According to the admission time,patients were divided into observation group and control group,with 300 cases in each group.Observation group received the evidence-based standardized transfer process for transfer care,and control group received routine transfer care.We compared the incidence of adverse transfer events and the satisfaction of patients'family members between the two groups.Results Sudden convulsions or restlessness,decreased blood oxygen saturation,blood pressure/heart rate fluctuations>20%,accidental slippage or blockage of catheters,infusion tube was off or blocked,insufficient oxygen,equipment failure,insufficient medicines of hospital transfer in observation group were 1.3%(4/300),7.0%(21/300),4.7%(14/300),0.3%(1/300),8.3%(25/300),0.3%(1/300),0.7%(2/300),0.3%(1/300),lower than 4.0%(12/300),22.3%(67/300),9.3%(28/300),3.0%(9/300),19.3%(58/300),2.7%(8/300),3.3%(10/300),6.0%(18/300)in control group,the differences were statistically significant(P<0.05).The overall satisfaction of patients'family members in observation group was 91.9%(262/285),which was higher than 69.0%(187/271)in control group,and the difference was statistically significant(P<0.01).Conclusions The implementation of an evidence-based standardized transfer process can effectively reduce the incidence of adverse events during the transfer in critically ill patients of neurosurgery and improve the satisfaction of patients'family members.