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分组随机质量控制对病房医生和护士针对院内心脏骤停患者复苏的急救能力的影响。

The Effect of Group Random Quality Control on the First Aid Ability of Ward Doctors and Nurses with Respect to the Resuscitation of Patients with In-Hospital Cardiac Arrest.

作者信息

Ji Jianhong, Wang Li, Guan Haiyang, Jiang Yaqiong, Zhou Sanlian, Sheng Junhua, Wang Lihua

机构信息

Intensive Care Unit, The Second Affiliated Hospital of Nantong University, Nantong, People's Republic of China.

Department of Emergency, The Second Affiliated Hospital of Nantong University, Nantong, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2021 Nov 9;14:4553-4560. doi: 10.2147/RMHP.S334142. eCollection 2021.

Abstract

OBJECTIVE

This study was designed to verify the effect of group random quality control on the first aid ability of ward doctors and nurses with regard to the resuscitation of patients with in-hospital cardiac arrest (IHCA).

METHODS

The first aid quality control team of our hospital was established in December 2018, when the number, qualifications, organizational structure, quality control methods, and responsibilities of the team and team members were determined. The baseline data and assessment results of examinees, the rates of return of spontaneous circulation (ROSC), and the discharge survival rate of IHCA patients in 2019 and 2020 were compared.

RESULTS

There were no significant differences in the baseline data of examinees at each stage (p > 0.05). As time went on, the results of the four practical examinations were significantly improved (pairwise comparison, p < 0.05). The number of problems in examinations was significantly higher for physicians than for nurses. After guidance in department relearning, the incidence of related problems was significantly reduced, but the mastery of the frequency and depth of extracorporeal cardiac compression were not always up to standard. The proportion of critically ill patients and the incidence of IHCA in the hospital in 2020 was higher than in 2019 (p < 0.05), and the ROSC rate was also significantly higher than it was in 2019 (p < 0.05), but the difference in the survival rate at discharge was not statistically significant (p > 0.05).

CONCLUSION

Group random quality control meets the needs of IHCA emergencies, and it can improve the first aid skills and organizational coordination of doctors and nurses on the ward through continuous discovery and problem solving so that the ultimate goal of improving the success rate of resuscitation can be achieved.

摘要

目的

本研究旨在验证分组随机质量控制对病房医生和护士进行院内心脏骤停(IHCA)患者复苏急救能力的影响。

方法

我院急救质量控制小组于2018年12月成立,确定了小组及成员的数量、资质、组织结构、质量控制方法和职责。比较了2019年和2020年考生的基线数据和评估结果、自主循环恢复(ROSC)率以及IHCA患者的出院生存率。

结果

各阶段考生的基线数据无显著差异(p>0.05)。随着时间的推移,四项实践考核结果有显著提高(两两比较,p<0.05)。医生考核中出现问题的数量显著高于护士。经过科室再学习指导后,相关问题的发生率显著降低,但体外心脏按压频率和深度的掌握情况并不总是达标。2020年医院重症患者比例和IHCA发生率高于2019年(p<0.05),ROSC率也显著高于2019年(p<0.05),但出院生存率差异无统计学意义(p>0.05)。

结论

分组随机质量控制符合IHCA急救的需求,通过持续发现和解决问题,可提高病房医生和护士的急救技能及组织协调能力,从而实现提高复苏成功率的最终目标。

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