心房颤动的急诊护理质量。
Quality of emergency room care for atrial fibrillation.
作者信息
Kyhälä-Valtonen Hanna, Lehto Mika, Rossinen Juhani, Pajari Risto, Mustonen Harri, Koponen Leena, Kohvakka Antti, Lehtonen Lasse, Toivonen Lauri, Voipio-Pulkki Liisa-Maria
机构信息
Department of Medicine, Helsinki University Central Hospital, POB 340, 00029 HUS, Helsinki, Finland.
出版信息
Scand Cardiovasc J. 2006 Oct;40(5):267-73. doi: 10.1080/14017430600889589.
OBJECTIVES
Atrial fibrillation (AF) is the most common arrhythmia in emergency rooms (ER). We surveyed the clinical characteristics and quality of care of AF patients in three emergency rooms in Helsinki, Finland.
DESIGN
Observational data of the treatment of 179 consecutive symptomatic AF patients were prospectively collected. The quality of care was analysed according to a predestined set of criteria.
RESULTS
Mean age of the patients was 63 years and 61% were men. The leading symptom was palpitation (86%). Sinus rhythm was achieved in 70%. New anticoagulation was initiated in 20% and cardiovascular medication modified in 42% of patients. Considering the overall quality of care, including documentation in the patient chart, it was classified as good in 53% of all patients, whereas the quality of therapeutic decisions and planning for follow-up was good in 77%.
CONCLUSIONS
The ER visit results in extensive treatment modifications in two of three patients. Although inadequate care is rare, maintaining good quality requires adherence to clinical guidelines, careful documentation and plans for follow-up.
目的
心房颤动（AF）是急诊室（ER）中最常见的心律失常。我们调查了芬兰赫尔辛基三家急诊室中房颤患者的临床特征及护理质量。
设计
前瞻性收集了179例连续有症状房颤患者的治疗观察数据。根据预先设定的标准分析护理质量。
结果
患者的平均年龄为63岁，61%为男性。主要症状为心悸（86%）。70%的患者恢复窦性心律。20%的患者开始新的抗凝治疗，42%的患者调整了心血管药物治疗。考虑到整体护理质量，包括患者病历中的记录，53%的患者被归类为良好，而治疗决策和随访计划的质量在77%的患者中为良好。
结论
在三分之二的患者中，急诊就诊导致了广泛的治疗调整。尽管护理不足的情况很少见，但要保持良好的质量需要遵循临床指南、仔细记录和制定随访计划。
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