Fry Margaret, Horvat Leanne, Roche Michael, Fong Jacqueline, Plowes Joanne
Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia.
Australas Emerg Nurs J. 2012 Aug;15(3):127-32. doi: 10.1016/j.aenj.2012.06.001.
Globally, severe infection and or sepsis is a problem that is costing billions of dollars, using hundreds of hospital beds, and often results in patient death. Any infection can potentially develop a sepsis health trajectory if left unrecognised and unmanaged.
We conducted a 12 month retrospective descriptive exploratory study. Our research explored the prevalence and triage characteristics of patients presenting with infection to one tertiary referral hospital. Electronic medical records were reviewed to identify patients that had a primary diagnosis related to infection.
The study identified that 16% (n=7756) of adult presentations had a discharge diagnosis related to infection. A significant difference (X(2)=297.83, df=4, p≤.001) in Triage Code allocation for the infection group was identified compared with the non-infection patient group. Thirty-nine percent (n=3027) of patients with infections were admitted to hospital. Of the patients (n=1930; 4%) admitted to a critical care area, 6% (n=122) had a primary diagnosis related to infection. Of the ED deaths (n=81), 12% (n=10) had a primary diagnosis related to infection.
The study provides a detailed analysis of the prevalence and triage characteristics of patients with infection presenting to one ED. Further research is needed to identify strategies to improve the triage nurse's recognition of severe infection and consistency of urgency code allocation to prevent patient deterioration.
在全球范围内,严重感染和/或脓毒症是一个耗费数十亿美元、占用数百张医院床位且常导致患者死亡的问题。任何感染若未被识别和处理,都有可能发展为脓毒症的健康轨迹。
我们进行了一项为期12个月的回顾性描述性探索性研究。我们的研究探讨了一所三级转诊医院中感染患者的患病率和分诊特征。通过查阅电子病历以识别那些有与感染相关的初步诊断的患者。
该研究发现,16%(n = 7756)的成人就诊病例有与感染相关的出院诊断。与非感染患者组相比,感染组在分诊代码分配上存在显著差异(X(2)=297.83,自由度 = 4,p≤.001)。39%(n = 3027)的感染患者入院治疗。在入住重症监护区的患者(n = 1930;4%)中,6%(n = 122)有与感染相关的初步诊断。在急诊死亡病例(n = 81)中,12%(n = 10)有与感染相关的初步诊断。
该研究对一所急诊科中感染患者的患病率和分诊特征进行了详细分析。需要进一步研究以确定改善分诊护士对严重感染的识别以及紧急代码分配一致性的策略,以防止患者病情恶化。