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危重症患者的院内转运:急诊护士的一项调查。

Intrahospital transport of critically ill patients: A survey of emergency nurses.

作者信息

Hu Yingli, Shi Donglei, You Lili, Li Wei

机构信息

Outpatient Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Nursing Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Nurs Crit Care. 2021 Sep;26(5):326-332. doi: 10.1111/nicc.12601. Epub 2021 Feb 10.

Abstract

BACKGROUND

Despite the frequency of its occurrence, few Chinese studies examined the status of intrahospital transport (IHT) of critically ill emergency room patients.

AIMS AND OBJECTIVES

To investigate the current status of IHT of critically ill patients and emergency nurses' perception of IHT across China; explore the perceived associations of written protocols with adverse events during IHT; and compare regional differences in IHT of critically ill patients across China.

DESIGN

A self-report questionnaire was conducted among the attendees of a large emergency medicine conference in Beijing in May 2015.

METHODS

The data, collected through convenience sampling, were analysed using descriptive statistics. Categorical variables were compared using the chi-squared test.

RESULTS

Of the 528 participants from 142 hospitals whose data were analysed, 19.3% considered all nurses competent enough to perform IHT of critically ill patients without special training, and 7.6% even considered nursing students capable of the task. The absence of written transport protocols was perceived to be significantly associated with the occurrence of adverse events such as oxygen supply depletion and incorrect destination. Hospitals in the western region were less likely to have established written IHT protocols and emergency checklists than those in the eastern region.

CONCLUSIONS

Safe IHT of critically ill patients in the emergency department involves enormous challenges. The results of this survey can facilitate a preliminary understanding of the characteristics and current situation of IHT in emergency settings across China.

RELEVANCE TO CLINICAL PRACTICE

The establishment of standard transport protocols may help reduce the incidence of adverse events.

摘要

背景

尽管医院内转运(IHT)在临床上频繁发生,但很少有中国研究调查急诊重症患者的院内转运情况。

目的

调查中国重症患者院内转运的现状以及急诊护士对院内转运的认知;探讨书面协议与院内转运期间不良事件之间的潜在关联;比较中国不同地区重症患者院内转运的差异。

设计

2015年5月在北京召开的一次大型急诊医学会议上,对参会人员进行了一项自填式问卷调查。

方法

通过便利抽样收集数据,并使用描述性统计方法进行分析。分类变量采用卡方检验进行比较。

结果

在分析数据的来自142家医院的528名参与者中,19.3%的人认为所有护士在未经特殊培训的情况下就有能力对重症患者进行院内转运,甚至7.6%的人认为护生也能胜任这项任务。人们认为缺乏书面转运协议与氧气供应中断和目的地错误等不良事件的发生显著相关。与东部地区的医院相比,西部地区的医院制定书面院内转运协议和急诊检查表的可能性较小。

结论

急诊科重症患者的安全院内转运面临巨大挑战。本次调查结果有助于初步了解中国急诊环境下院内转运的特点和现状。

与临床实践的相关性

制定标准转运协议可能有助于降低不良事件的发生率。

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