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急诊科高级分诊方案：系统评价和荟萃分析。

Advanced triage protocols in the emergency department: A systematic review and meta-analysis.

机构信息

Grupo Hospitalar Conceição, Gerência de Ensino e Pesquisa, Porto Alegre, RS, Brasil.

Grupo Hospitalar Conceição, Porto Alegre, RS, Brasil.

出版信息

Rev Lat Am Enfermagem. 2022;30:e3511. doi: 10.1590/1518-8345.5479.3511.

DOI:10.1590/1518-8345.5479.3511
PMID:35293563
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8966058/
Abstract

OBJECTIVE

To evaluate the effectiveness of using advanced triage protocols on the length of stay, safety and satisfaction of the patients and professionals in the emergency department.

METHOD

A systematic review with meta-analysis of randomized clinical trials included in the Embase, BVS, PubMed, CINAHL, Cochrane Library databases and in the gray literature, using Review Manager 5.4. Studies that analyzed length of stay in their outcomes were included and the studies excluded were those that considered other triage protocols.

RESULTS

26,672 peer-reviewed studies were found and ten were included in the meta-analysis. For the patients' length of stay, seven studies were included in the meta-analysis (n=8,229), showing a 36-minute reduction (-0.36[-0.55;-0.17] p=0.002), a result with low certainty of evidence, favorable to the intervention, varying between -0.53 (-0.81;- 0.25) and -0.29 (-0.50;-0.07) in the analysis of the subgroups. Regarding the exams requested, five studies were included (n=2,270), indicating that there is no significant difference between the groups (odds ratio 0.94 [0.64;1.38]). Four studies (n=6,094) analyzed the patients' and the professionals' satisfaction, indicating a favorable result to the intervention.

CONCLUSION

The advanced triage protocol reduced length of stay in the emergency room without compromising care safety and quality, although more randomized clinical studies on the theme are needed. Registered in PROSPERO (CRD42019142640).

摘要

目的

评估使用高级分诊方案对急诊科患者和专业人员的停留时间、安全性和满意度的效果。

方法

对 Embase、BVS、PubMed、CINAHL、Cochrane 图书馆数据库和灰色文献中的随机临床试验进行系统评价和荟萃分析，使用 Review Manager 5.4。分析结果中停留时间的研究被纳入，而考虑其他分诊方案的研究则被排除在外。

结果

共发现 26,672 篇同行评议研究，其中 10 项研究纳入荟萃分析。对于患者的停留时间，有 7 项研究纳入荟萃分析（n=8,229），显示减少 36 分钟（-0.36[-0.55;-0.17]p=0.002），证据确定性低，干预结果有利，亚组分析中差异范围为-0.53（-0.81;-0.25）至-0.29（-0.50;-0.07）。关于请求的检查，有 5 项研究纳入（n=2,270），表明两组之间无显著差异（比值比 0.94 [0.64;1.38]）。四项研究（n=6,094）分析了患者和专业人员的满意度，表明干预结果有利。

结论

高级分诊方案缩短了急诊室的停留时间，同时不影响护理安全和质量，但仍需要更多关于该主题的随机临床试验。在 PROSPERO（CRD42019142640）注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/a145b92b007a/1518-8345-rlae-30-e3511-gf10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/162c5936da92/1518-8345-rlae-30-e3511-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/b548a99245eb/1518-8345-rlae-30-e3511-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/44bff4a5e2bf/1518-8345-rlae-30-e3511-gf8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/dbce9f825564/1518-8345-rlae-30-e3511-gf9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/a145b92b007a/1518-8345-rlae-30-e3511-gf10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/162c5936da92/1518-8345-rlae-30-e3511-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/b548a99245eb/1518-8345-rlae-30-e3511-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/44bff4a5e2bf/1518-8345-rlae-30-e3511-gf8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/dbce9f825564/1518-8345-rlae-30-e3511-gf9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fc6/8966058/a145b92b007a/1518-8345-rlae-30-e3511-gf10.jpg

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