危重症患者预告沟通质量和预计到达时间的准确性：一项前瞻性观察研究。
The quality of pre-announcement communication and the accuracy of estimated arrival time in critically ill patients, a prospective observational study.
机构信息
Department of Emergency Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Associate professor Emergency and Critical Health Care, HAN University of Applied Sciences Nijmegen, The Netherlands; Radboud University Medical Centre, Nijmegen, The Netherlands.
出版信息
BMC Emerg Med. 2022 Mar 19;22(1):44. doi: 10.1186/s12873-022-00601-z.
BACKGROUND
Efficient communication between (helicopter) emergency medical services ((H)EMS) and healthcare professionals in the emergency department (ED) is essential to facilitate appropriate team mobilization and preparation for critically ill patients. A correct estimated time of arrival (ETA) is crucial for patient safety and time-management since all team members have to be present, but needless waiting must be avoided. The aim of this study is to investigate the quality of the pre-announcement and the accuracy of the ETA.
METHODS
A prospective observational study was conducted in potentially critically ill/injured patients transported to the ED of a Level I trauma center by the (H)EMS. Research assistants observed time slots prior to arrival at the ED and during the initial assessment, using a stopwatch and an observation form. Information on the pre-announcement (including mechanisms of injury, vital signs, and the ETA) is also collected.
RESULTS
One hundred and ninety-three critically ill/injured patients were included. Information in the pre-announcement was often incomplete; in particular vital signs (86%). Forty percent of the announced critically ill patients were non-critical at arrival in the ED. The observed time of arrival (OTA) for 66% of the patients was later than the provided ETA (median 5:15 min) and 19% of the patients arrived sooner (3:10 min). Team completeness prior to the arrival of the patient was achieved for 66% of the patients.
CONCLUSIONS
The quality of the pre-announcement is moderate, sometimes lacking essential information on vital signs. Forty percent of the critically ill patients turned out to be non-critical at the ED. Furthermore, the ETA was regularly inaccurate and team completeness was insufficient. However, none of the above was correlated to the rate of complications, mortality, LOS, ward of admission or discharge location.
背景
（直升机）紧急医疗服务（(H)EMS）与急诊科（ED）的医疗专业人员之间进行高效沟通对于促进适当的团队动员和为危重病患者做好准备至关重要。准确的预计到达时间（ETA）对于患者安全和时间管理至关重要，因为所有团队成员都必须到场，但必须避免不必要的等待。本研究的目的是调查预告的质量和 ETA 的准确性。
方法
本前瞻性观察研究在（H)EMS 转运至一级创伤中心 ED 的潜在危重病/伤患者中进行。研究助理使用秒表和观察表在到达 ED 之前和初始评估期间观察时间区间。还收集有关预告（包括损伤机制、生命体征和 ETA）的信息。
结果
共纳入 193 例危重病/伤患者。预告信息经常不完整；特别是生命体征（86%）。到达 ED 时，宣布的 40%危重病患者并非真正的危重病。观察到的到达时间（OTA）对于 66%的患者晚于提供的 ETA（中位数 5:15 分钟），19%的患者提前到达（3:10 分钟）。在患者到达之前，团队完整性达到了 66%。
结论
预告的质量中等，有时缺乏生命体征等重要信息。到达 ED 时，40%的危重病患者并非真正的危重病。此外，ETA 经常不准确，团队完整性不足。然而，上述任何一项都与并发症、死亡率、 LOS、入院病房或出院地点的发生率无关。
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