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迈向更智能的小儿创伤护理模式：识别创伤团队启动的时间变化。

Towards a more intelligent model of providing pediatric trauma care: identifying temporal variations in trauma team activations.

作者信息

Johnson Arianne, Sharma Rohit, Anis John, Kaminski Stephen, Kanard Robert

机构信息

Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, California, USA.

Trauma, Santa Barbara Cottage Hospital, Santa Barbara, California, USA.

出版信息

Trauma Surg Acute Care Open. 2020 Nov 11;5(1):e000448. doi: 10.1136/tsaco-2020-000448. eCollection 2020.

DOI:10.1136/tsaco-2020-000448
PMID:33225069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7661376/
Abstract

BACKGROUND

Trauma centers are resource-intensive environments, and pediatric-specific personnel are often limited resources. Identifying the temporal patterns of pediatric traumas can help guide resource allocation strategies to optimize patient care.

METHODS

We conducted a retrospective, single-institution analysis of 575 injured patients less than 18 years old that triggered a trauma team activation (TTA). TTA volume according to time of day and day of the week was analyzed using a mixed Poisson regression model and monthly patterns were analyzed using an analysis of variance. Subset analyses were conducted for children and teenagers.

RESULTS

Across all days, the 6-hour time frame between 15:00 and 21:00 had significantly more activations than average, encompassing nearly half (47.2%) of all pediatric TTAs (p=0.01). Saturdays had significantly more activations than the daily average (Saturdays: 26.0/year, Other: 14.8/year, p<0.01). A pediatric TTA was 3.6 times more likely to occur between 15:00 and 21:00 on a Saturday than any other time. Volume of activation did not significantly differ by month (p=0.880).

CONCLUSION

The volume of pediatric trauma activations varies significantly according to time of day and day of the week. These findings can direct or validate resource allocation strategies such as staffing physicians, nurses, and ancillary personnel according to TTA volume.

TYPE OF STUDY

Retrospective cohort study.

LEVEL OF EVIDENCE

Level III.

摘要

背景

创伤中心是资源密集型环境，而儿科专科人员往往是有限资源。识别儿科创伤的时间模式有助于指导资源分配策略，以优化患者护理。

方法

我们对一家机构的575名18岁以下受伤患者进行了回顾性分析，这些患者触发了创伤团队激活（TTA）。使用混合泊松回归模型分析了按一天中的时间和一周中的日期划分的TTA数量，并使用方差分析分析了月度模式。对儿童和青少年进行了亚组分析。

结果

在所有日子里，15:00至21:00的6小时时间段内的激活次数明显多于平均水平，占所有儿科TTA的近一半（47.2%）（p = 0.01）。周六的激活次数明显多于每日平均水平（周六：每年26.0次，其他：每年14.8次，p < 0.01）。周六15:00至21:00发生儿科TTA的可能性是其他任何时间的3.6倍。激活数量在各月份之间无显著差异（p = 0.880）。

结论

儿科创伤激活的数量根据一天中的时间和一周中的日期有显著差异。这些发现可以指导或验证资源分配策略，如根据TTA数量配备医生、护士和辅助人员。

研究类型

回顾性队列研究。

证据水平

三级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/3ca1e1c685b2/tsaco-2020-000448f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/5dca6bfb1b0d/tsaco-2020-000448f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/c66c4d93dfcd/tsaco-2020-000448f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/3ca1e1c685b2/tsaco-2020-000448f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/5dca6bfb1b0d/tsaco-2020-000448f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/c66c4d93dfcd/tsaco-2020-000448f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/7661376/3ca1e1c685b2/tsaco-2020-000448f03.jpg

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Temporal Variations in Pediatric Trauma: Rationale for Altered Resource Utilization.
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