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非转运患者在紧急医疗服务(EMS)中的时间消耗:瑞典一地区为期一年的前瞻性描述性和对照研究。

Time consumption for non-conveyed patients within emergency medical services (EMS): A one-year prospective descriptive and comparative study in a region of Sweden.

机构信息

Department of Emergency Care, Örebro University Hospital, Örebro, Region Örebro County, Sweden.

University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

出版信息

PLoS One. 2021 May 13;16(5):e0251686. doi: 10.1371/journal.pone.0251686. eCollection 2021.

Abstract

INTRODUCTION

Over time, ambulance assignments have increased in number both nationally and internationally, and a substantial proportion of patients encountered by emergency medical services are assessed as not being in need of services. Non-conveying patients has become a way for emergency medical services clinicians to meet this increasing workload. It has been shown that ambulances can be made available sooner if patients are non-conveyed, but there is no previous research describing the factors that influence the non-conveyance time.

STUDY OBJECTIVE

To describe ambulance time consumption and the factors that influence time consumption when patients are non-conveyed.

METHODS

A prospective observational review of 2615 non-conveyed patients' ambulance and hospital medical records was conducted using a consecutive sample. Data were analysed with the Kruskal-Wallis test, Mann-Whitney U test and Spearman's rank correlation (rho) for linear correlations.

RESULTS

The mean NC time for all ambulance assignments during the study period was 26 minutes, with a median of 25 minutes. The shortest NC time was 4 minutes, and the longest NC time was 73 minutes. NC times were significantly faster during the day than at night.

CONCLUSIONS

This study provides new knowledge about time consumption when patients are non-conveyed. Although there are time differences when patients are non-conveyed, the differences observed in this study are small and not of clinical value. Ambulances will most often become available sooner if patients are non-conveyed. Although patients might be eligible for non-conveyance, policy-makers might have to decide when it is appropriate to non-convey patients from time, resource, patient safety and patient-centred care perspectives.

摘要

简介

随着时间的推移,国内外的救护车任务数量都有所增加,大量遇到的紧急医疗服务的患者被评估为不需要服务。不转运患者已成为紧急医疗服务临床医生应对这种工作量增加的一种方式。已经表明,如果不转运患者,救护车可以更快地投入使用,但以前没有研究描述影响非转运时间的因素。

研究目的

描述非转运患者的救护车时间消耗和影响时间消耗的因素。

方法

使用连续样本对 2615 名非转运患者的救护车和医院病历进行了前瞻性观察性回顾。使用 Kruskal-Wallis 检验、Mann-Whitney U 检验和 Spearman 秩相关(rho)进行线性相关性分析。

结果

在研究期间,所有救护车任务的平均 NC 时间为 26 分钟,中位数为 25 分钟。最短的 NC 时间为 4 分钟,最长的 NC 时间为 73 分钟。NC 时间在白天明显快于夜间。

结论

本研究提供了有关非转运患者时间消耗的新知识。尽管非转运患者的时间存在差异,但本研究观察到的差异很小,没有临床价值。如果不转运患者,救护车通常会更快地投入使用。尽管患者可能有资格不被转运,但从时间、资源、患者安全和以患者为中心的护理角度来看,政策制定者可能不得不决定何时适当地不转运患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7db/8118495/6a17e36907ba/pone.0251686.g001.jpg

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