抢救案例分享结合应急预演对急诊预检分诊质量及护士工作能力的影响

何佳涛; 沈小玲

doi:10.16766/j.cnki.issn.1674-4152.001754

抢救案例分享结合应急预演对急诊预检分诊质量及护士工作能力的影响

doi: 10.16766/j.cnki.issn.1674-4152.001754

何佳涛,
沈小玲^,

浙江中医药大学第四临床医学院杭州市第一人民医院急诊科，浙江杭州 310003

基金项目:

浙江省医药卫生科技计划一般项目 2019KY124

详细信息

通讯作者:
沈小玲, E-mail: hzshenxiaoling@126.com

中图分类号: R459.7 R472.2
计量
- 文章访问数: 240
- HTML全文浏览量: 102
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2019-12-30
- 网络出版日期: 2022-02-19

Effect of rescue case sharing combined with emergency preview on the quality of emergency pre-examination and triage and the working ability of nurses

HE Jia-tao,
SHEN Xiao-ling^,

Emergency Department, Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310003, China

摘要

摘要: 目的探讨抢救案例分享结合应急预演对急诊预检分诊质量、护士工作能力和护理满意度的影响情况。方法选择2017年1月—2019年1月杭州市第一人民医院急诊科58名护理人员为研究对象，2017年1月—2017年12月为常规急诊期，此段时期护理人员以常规的急诊抢救等工作安排，2018年1月—2019年1月为新管理急诊期，此段时期护理人员在常规急诊期的有关管理安排下，加入抢救案例分享+应急预演新管理内容。观察对比不同阶段的急诊预检分诊质量、护士工作能力和护理满意度。结果新管理急诊期的急诊分诊准确率为99.11%、抢救成功率为97.90%明显高于常规急诊期的95.61%和94.01%，新管理急诊期抢救单元物品缺失率为0.80%显著低于常规急诊期的8.13%，差异均存在统计学意义(均P < 0.01)。新管理急诊期的帮助角色能力、教育-指导能力、评估判断能力、应对能力、护理干预能力、质量评价能力和工作角色能力评分明显高于常规急诊期，差异均有统计学意义(均P < 0.05)。新管理急诊期的护理总满意率是90.91%，常规急诊期的总满意率是76.36%，新管理急诊期明显优于常规急诊期，差异具有统计学意义(χ²=4.251，P < 0.05)。结论抢救案例分享+应急预演的急诊管理措施，提高预检分诊的整体正确率，提升治疗效果和服务质量，减少医患纠纷，提高医疗服务满意度。
- 急诊 /
- 预检分诊 /
- 抢救案例分享 /
- 应急预演 /
- 护士工作能力 /
- 护理满意度
Abstract: Objective To explore the effect of rescue case sharing combined with emergency rehearsal on the quality of emergency pre-examination and triage, nurses' work ability and nursing satisfaction. Methods We selected 58 nurses from the emergency department of Hangzhou First People's Hospital from January 2017 to January 2019 as the research object, and January 2017 to December 2017 as the routine emergency department period. The personnel were arranged for routine emergency rescue and other work arrangements. From January 2018 to January 2019, it was the new management emergency department. During this period, the nursing staff joined the rescue case sharing + emergency preview new management content under the relevant management arrangements of the regular emergency department. The quality of emergency pre-examination and triage, the working ability of nurses and the satisfaction of nursing in different stages were observed and compared. Results The accuracy rate of emergency triage in the newly managed emergency department was 99.11%, and the rescue rate was 97.90%, which was significantly higher than 95.61% and 94.01% in the conventional emergency department, respectively. The missing rate (0.80%) in the rescue unit of the newly managed emergency department was significantly lower than that in the conventional emergency department (8.13%). The differences were statistically significant (all P < 0.01). The help role ability, education-guidance ability, evaluation and judgment ability, coping ability, nursing intervention ability, quality evaluation ability and job role ability score of the new management emergency period were significantly higher than those in the conventional emergency period, and there were statistical differences between the comparisons (all P < 0.05). The total satisfaction rate of nursing in the newly-managed emergency department was 90.91%, and the total satisfaction rate in the conventional emergency department was 76.36%. The newly-managed emergency department was significantly better than the conventional emergency department. The comparison was significant and statistically significant (χ²=4.251, P < 0.05). Conclusion The sharing of rescue cases + emergency management measures for emergency rehearsal can improve treatment effect and service quality, reduce doctor-patient disputes, and improve medical service satisfaction.
- Emergency department /
- Pre-examination and triage /
- Rescue case sharing /
- Emergency rehearsal /
- Working ability of nurses /
- Nursing satisfaction

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表 1 急诊预检分诊质量对比[例(%)]

阶段	例数	急诊分诊准确率	抢救成功率	抢救单元物品缺失率
新管理急诊期	12 236	12 127(99.11)	11 979(97.90)	98(0.80)
常规急诊期	12 180	11 645(95.61)	11 450(94.01)	990(8.13)
χ²值		147.395	119.769	392.502
P值		< 0.001	< 0.001	< 0.001

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表 2 护士工作能力评分对比(x ±s)

阶段	例数	帮助角色能力	教育-指导能力	评估判断能力	应对能力	护理干预能力	质量评价能力	工作角色能力
常规急诊期	58	73.23±9.38	77.01±9.84	76.53±10.84	78.81±10.48	74.45±9.75	73.95±9.57	79.48±9.38
新管理急诊期	58	79.11±10.52	83.18±9.96	82.48±10.04	84.37±9.57	79.57±9.10	79.58±10.46	85.15±9.84
t值		3.177	3.356	3.067	2.984	2.924	4.429	3.176
P值		0.002	0.001	0.003	0.004	0.004	< 0.001	0.002

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表 3 2组护理满意度比较[例(%)]

组别	抽样数	非常满意	满意	不满意	总满意度
新管理急诊期	55	28 (49.09)	22 (40.00)	5(9.09)	90.91
常规急诊期	55	17 (30.91)	25 (45.45)	13 (23.64)	76.36
统计量			2.485^a		4.251^b
P值			0.013		0.039
注：^a为U值，^b为χ²值。

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参考文献(19)

[1]	闫素蕾, 刘玉峰, 李昆. 抢救案例分享对急诊预检分诊质量的影响[J]. 当代护士(中旬刊), 2016(12): 167-168. https://www.cnki.com.cn/Article/CJFDTOTAL-DDHS201612089.htm
[2]	刘玉峰, 姜晓真. 抢救案例分享对提升急诊科护理人员综合急救能力的影响[J]. 中国临床护理, 2017, 9(1): 65-68. doi: 10.3969/j.issn.1674-3768.2017.01.022
[3]	黄慧懿, 钱湘云, 孙月, 等. 思维导图在提高传染科护士临床工作能力中的应用研究[J]. 护士进修杂志, 2019, 34(15): 1374-1378. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201915007.htm
[4]	赵丽娟. 专家共识指导下急诊预检分诊护理工作质量持续改进效果评价[J]. 临床医药文献电子杂志, 2018, 5(96): 15-17. doi: 10.3877/j.issn.2095-8242.2018.96.009
[5]	冯新萍, 余志娟. 综合医院门诊运用PDCA提高预检分诊质量的研究[J]. 湖北科技学院学报: 医学版, 2019, 33(4): 340-343. https://www.cnki.com.cn/Article/CJFDTOTAL-XNYB201904023.htm
[6]	余艮珍, 张晓乐, 叶天惠, 等. 两种预检分诊模式对三级综合医院儿科急诊分诊质量的影响[J]. 护士进修杂志, 2016, 31(14): 1283-1287. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201614010.htm
[7]	姜永梅, 姜艳, 郭鹏菊, 等. 急救情景模拟演练对急诊护士抢救能力的作用评价[J]. 中国中医急症, 2014, 24(8): 1494-1495, 1497. doi: 10.3969/j.issn.1004-745X.2014.08.041
[8]	詹美莺, 罗小燕. 案例分享对手术室护理质量的影响[J]. 福建医药杂志, 2016, 38(6): 176-177. https://www.cnki.com.cn/Article/CJFDTOTAL-FJYY201606074.htm
[9]	王晓燕, 沈小玲. 急诊护士预检分诊能力调查及影响因素分析[J]. 中华全科医学, 2019, 17(12): 2131-2134. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201912041.htm
[10]	刘兰芹, 叶丽. 急诊护理中的暴力风险因素分析及预防对策[J]. 中国基层医药, 2017, 24(1): 158-160. doi: 10.3760/cma.j.issn.1008-6706.2017.01.042
[11]	王宏秋, 游兆媛, 丁舒, 等. 国内外急诊预检分诊工具的应用进展[J]. 中国病案, 2017, 18(12): 51-54. doi: 10.3969/j.issn.1672-2566.2017.12.020
[12]	金静芬, 郭芝廷. 国内三甲医院急诊预检分诊现状与对策研究[J]. 中华急诊医学杂志, 2015, 24(4): 458-461. doi: 10.3760/cma.j.issn.1671-0282.2015.04.031
[13]	谢咏湘, 李映兰, 石莲桂, 等. 急诊预检分诊护士核心能力评价指标体系的构建[J]. 中国护理管理, 2018, 18(5): 641-646. doi: 10.3969/j.issn.1672-1756.2018.05.014
[14]	蔡小狄, 陆国平. 急诊预检分诊技术[J]. 中华实用儿科临床杂志, 2018, 33(6): 401-404. doi: 10.3760/cma.j.issn.2095-428X.2018.06.001
[15]	周炜. 国内急诊预检分诊信息化管理的研究现状[J]. 护理研究, 2018, 32(13): 2018-2020. doi: 10.12102/j.issn.1009-6493.2018.13.008
[16]	中华护理学会急诊专业委员会, 浙江省急诊医学质量控制中心. 急诊预检分级分诊标准[J]. 中华急诊医学杂志, 2016, 25(4): 415-417. doi: 10.3760/cma.j.issn.1671-0282.2016.04.004
[17]	冯丽, 陈潇, 施辉, 等. 急诊科护士从事预检分诊工作的促进与障碍因素的质性分析[J]. 中华现代护理杂志, 2019, 25(11): 1388-1392. doi: 10.3760/cma.j.issn.1674-2907.2019.11.016
[18]	急诊预检分诊专家共识组, 史冬雷, 刘晓颖, 等. 急诊预检分诊专家共识[J]. 中华急诊医学杂志, 2018, 27(6): 599-604. doi: 10.3760/cma.j.issn.1671-0282.2018.06.006
[19]	彭姗, 蒋伟, 朱聚. 应用思维导图在急诊预检分诊岗位培训的应用和临床观察[J]. 中国地方病防治杂志, 2018, 33(6): 663-664. https://www.cnki.com.cn/Article/CJFDTOTAL-DYBF201806031.htm