Daniel Ana Carolina Queiroz Godoy, Veiga Eugenia Velludo, Mafra Ana Carolina Cintra Nunes
Israelite Albert Einstein Hospital, Chácara Klabin Advanced Unit, Av. Dr. Ricardo Jafet, 1600, Vila Mariana, 14115-000 São Paulo, SP, Brazil.
Ribeirão Preto College of Nursing, University of São Paulo - Prof. Hélio Lourenço, 3900 - Vila Monte Alegre, 14040-902 Ribeirão Preto, SP, Brazil.
Int Emerg Nurs. 2019 Nov;47:100787. doi: 10.1016/j.ienj.2019.100787. Epub 2019 Sep 4.
To associate blood pressure (BP) documentation with adverse outcomes in an emergency department (ED).
This is a retrospective observational study, and 642 records of patients admitted to the ED of a tertiary hospital in Brazil were used. We included medical records of patients of both sexes aged over 18 years, who were allocated in general wards in the period December 2015-June 2016. Association between BP measurements with length of stay (LOS), worsening of clinical presentation, unplanned patient transfer, readmission, stroke or transient ischemic attack, cardiorespiratory arrest, and death were investigated.
Association was observed between worsening of clinical presentation and systolic (p = 0.003) or diastolic (p = 0.001) BP values. The association between LOS and worsening of clinical presentation with the number of BP measurements or mean time between BP measurements was statistically significant (p < 0.001). Unplanned patient transfer was associated with an increase in the number of BP measurements (p < 0.001). The mean time between BP measurements was higher among patients who returned to the ED within 48-72 h (p = 0.030).
The results of this study showed association between BP documentation with adverse outcomes in the ED, reinforcing the need to develop educational strategies regarding nursing records and monitoring of vital signs.
探讨急诊科（ED）血压（BP）记录与不良结局之间的关联。
这是一项回顾性观察研究，使用了巴西一家三级医院急诊科收治的642例患者的记录。我们纳入了年龄超过18岁的男女患者的病历，这些患者于2015年12月至2016年6月期间被分配到普通病房。研究了血压测量与住院时间（LOS）、临床表现恶化、非计划患者转运、再入院、中风或短暂性脑缺血发作、心肺骤停及死亡之间的关联。
观察到临床表现恶化与收缩压（p = 0.003）或舒张压（p = 0.001）值之间存在关联。住院时间和临床表现恶化与血压测量次数或血压测量之间的平均时间之间的关联具有统计学意义（p < 0.001）。非计划患者转运与血压测量次数增加相关（p < 0.001）。在48 - 72小时内返回急诊科的患者中，血压测量之间的平均时间更长（p = 0.030）。
本研究结果显示急诊科血压记录与不良结局之间存在关联，这进一步凸显了制定有关护理记录和生命体征监测的教育策略的必要性。
