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急诊科的静脉血栓栓塞症:中国医生和护士当前最佳实践认知情况调查

Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China.

作者信息

Zhou Wen-Hua, He Jian-Qiang, Guo Shi-Gong, Walline Joseph, Liu Xiao-Ying, Tian Li-Yuan, Zhu Hua-Dong, Yu Xue-Zhong, Li Yi

机构信息

Emergency Department, Peking Union Medical College Hospital, Beijing, China.

Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK.

出版信息

World J Emerg Med. 2019;10(1):5-13. doi: 10.5847/wjem.j.1920-8642.2019.01.001.

Abstract

BACKGROUND

For emergency department (ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism (VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE.

METHODS

We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.

RESULTS

In this survey, 180 questionnaires were distributed and 174 valid responses (response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no significant differences were found with respect to job (doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years (=83) scored significantly higher on the questionnaire than those under 5 years (=91) (95.75 vs. 79.97, =0.039). There was a significant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.

CONCLUSION

Our survey has shown deficiencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events (including VTE).

摘要

背景

对于急诊科患者,静脉血栓栓塞症(VTE)的风险评估、预防、早期诊断和恰当治疗对于预防发病和死亡至关重要。本研究旨在调查急诊医护人员在VTE管理方面的知识。

方法

我们设计了一份基于多个量表的问卷。该问卷分发给中国北方某医疗中心大型城市急诊科的医护临床人员。数据用百分比描述,采用Kruskal-Wallis检验比较不同组之间的排序数据。使用SPSS 22.0软件进行统计分析。

结果

在本次调查中,共发放180份问卷,收集并分析了174份有效回复(回复率为96.67%)。在VTE知识得分方面,在工作(医生与护士)、临床工作年限、教育水平、当前职位、既往医院工作经验以及护士在急诊科的当前工作地点等方面未发现显著差异。然而,在两两比较中,我们发现急诊科工作超过5年的参与者(n = 83)在问卷上的得分显著高于工作年限不足5年的参与者(n = 91)(95.75对79.97,P = 0.039)。在一些问题上,基于性别、年龄、工作、护士工作地点、工作年限、教育水平以及不同的急诊科工作时长存在显著差异。

结论

我们的调查显示急诊科医护人员在VTE管理的知识和意识方面存在不足。我们建议考虑进行多项改进,例如为医护人员举办跨学科研讨会;引入标准化的VTE方案;为新入职的医生和护士设置VTE必修学习模块;引入不良事件(包括VTE)强制报告系统。

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