标准化急救护理流程在规范儿科急诊护士急救护理行为中的应用
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摘要
目的 :应用标准化急救护理流程,规范儿科急诊护士的急救护理行为,提高抢救质量,保障患儿安全。方法 :将2016年7-12月在我院儿科急诊实施急救的患儿402例设为对照组,2017年1-6月在我院儿科急诊实施急救的患儿396例设为实验组。对照组患儿给予常规急救护理,实验组制定并应用标准化的急救护理流程,并对急救护理工作进行持续的质量控制。比较两组患儿的抢救室滞留率、护士的抢救医嘱延迟执行率、护士的急救处置行为正确率和不良事件发生率的差异。结果 :实验组的抢救室滞留率、抢救医嘱延迟执行率、不良事件发生率均明显低于对照组(P<0.05);实验组的护士急救处置行为正确率高于对照组(P<0.05)。结论 :应用标准化急救护理流程能有效规范护士的急救护理行为,提高急救护理质量。
Objective: Standard emergency nursing procedures were employed to standardize pediatric nurses' emergency care behaviors and improve their rescue quality for the sake of guaranteeing safety of children. Methods: Totally 402 children admitted to the Pediatric Emergency Department of the hospital during July to December in 2016 were recruited into the control group, and another 396 children admitted to the department from January to June in 2017 were recruited into the observation group. Children in the control group were given traditional emergency care, while children in the observation group received emergency care based on standard emergency nursing procedures with continuous quality control. Indicators including rescue room retention rate, rate of delayed medical advice execution, accuracy rate of treatment and incidence of adverse events were compared between the two groups. Results: The observation group had less rescue room retention, less delayed execution of medical advice and less adverse events compared to the control group(P<0.05), and the accuracy rate of treatment was higher(P<0.05). Conclusion: It's useful to standardize pediatric nurses' emergency care behaviors to improve emergency nursing by adopting standard emergency nursing procedures, which is worth application and popularization.
Objective: Standard emergency nursing procedures were employed to standardize pediatric nurses' emergency care behaviors and improve their rescue quality for the sake of guaranteeing safety of children. Methods: Totally 402 children admitted to the Pediatric Emergency Department of the hospital during July to December in 2016 were recruited into the control group, and another 396 children admitted to the department from January to June in 2017 were recruited into the observation group. Children in the control group were given traditional emergency care, while children in the observation group received emergency care based on standard emergency nursing procedures with continuous quality control. Indicators including rescue room retention rate, rate of delayed medical advice execution, accuracy rate of treatment and incidence of adverse events were compared between the two groups. Results: The observation group had less rescue room retention, less delayed execution of medical advice and less adverse events compared to the control group(P<0.05), and the accuracy rate of treatment was higher(P<0.05). Conclusion: It's useful to standardize pediatric nurses' emergency care behaviors to improve emergency nursing by adopting standard emergency nursing procedures, which is worth application and popularization.
引文
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[16]Campbell RL,Li JT,Nicklas RA,et al.Emergency department diagnosis and treatment of anaphylaxis:a practice parameter.Ann Allergy Asthma Immunol,2014,113(6):599-608.
[17]周桂侠.急救流程培训在妇科新护士带教中的应用.中华护理教育,2012(10):472-473.Zhou GX.The application of emergency care process training in new gynecological nurse.Chinese Journal of Nursing Education,2012(10):472-473.
[18]刘金金.ABC定位培训模式在提高护士对重点病种急救流程认知中的应用.齐鲁护理杂志,2015(4):110-111.Liu JJ.Application of ABC location training mo de in improving nurses'acknowledge of emergency management process of the key diseases.J Qilu Nurs,2015(4):110-111.
[19]冯小华,姬宇,马晓敏,等.运用定位抢救模式提高急诊护士儿科急救能力的体会.中国伤残医学,2014(2):280-281.Feng XH,Ji Y,Ma XM,et al.To improve pediatric emergency nurses'emergency care ability by use of location rescue mode.Chinese Journal of Trauma and Disability Medicine,2014(2):280-281.
[20]Sandhu N,Eppich W,Mikrogianakis A,et al.Post resuscitation debriefing in the pediatric emergency depar tment:a national needs assessment.CJEM,2014,16(5):383-392.
[21]Callegaro S,Titomanlio L,Donega S,et al.Implementation of a febrile seizure guideline in two pediatric emergency departments.Pediatr Neurol,2009,40(2):78-83.
[22]马文萃.PDCA在产科优质护理服务中的应用.护理实践与研究,2014(3):45-46.Ma WC.Application of PDCA in high quality nursing service in obstetrics.Nursing Practice and Research,2014(3):45-46.
[23]杨立文,王玉生.PDCA循环管理模式在急诊护理管理中的应用.实用临床护理学电子杂志,2017(3):163-166.Yang LW,Wang YS.Application of PDCAmanagement mode in emergency nursing management.Journal of Clinic Nursing's Practicality,2017(3):163-166.
[24]孙英莉.PDCA模式对急诊科护理质量及抢救有效率的影响分析.中国医学工程,2015(1):127.Sun YL.Impact of PDCA mode on emergency nursing quality and rescue efficiency.China Medical Engineering,2015(1):127.
[25]吴妙桓,郭剑虹,郑瑞琪,等.PDCA循环管理法在急诊科低年资护士培训中的应用.中国医学创新,2013(18):81-84.Wu MH,Guo JH,Zheng RQ,et al.Application of PDCA circulation mode in training of new nurse in emergency department.Medical Innovation of China,2013(18):81-84.
[26]郑军,贾冬云,向红.PDCA管理方法在提高呼吸科危重症患者抢救成功率中的作用.护理实践与研究,2014(8):115-117.Zheng J,Jia DY,Xiang H.Application of PDCAmethod in improving rescue efficiency in RICU.Nursing Practice and Research,2014(8):115-117.
[2]Ruddy RM,Chamberlain JM,Mahajan PV,et al.Near misses and unsafe conditions reported in a Pediatric Emergency Research Network.BMJ Open,2015,5(9):e7541.
[3]Shaw KN,Lillis KA,Ruddy RM,et al.Reported medication events in a paediatric emergency research network:sharing to improve patient safety.Emergency Medicine Journal,2013,30(10):815-819.
[4]张少丽,韩萍,魏薇萍,等.综合性三级甲等医院急诊抢救室病人滞留相关因素分析.护理研究,2016(21):2602-2605.Zhang SL,Han P,Wei WP,et al.Factors affecting the retention of patients in emergency room in grade III a hospital.Nursing Research,2016(21):2602-2605.
[5]王岚,张其红.基于急救流程交班模板的设计及在晨会交班中的应用.护理学杂志,2015(20):71-73.Wang L,Zhang QH.Design of nursing handover report templates based on first-aid process and their application in morning shift handover meeting.Journal of Nursing Science,2015(20):71-73.
[6]Larenas-Linnemann D,Salas-Hernandez J,Vazquez-Garcia JC,et al.Mexican asthma guidelines:GUIMA 2017.Rev Alerg Mex,2017,64 Suppl 1:s11-s128.
[7]Malmgren B,Andreasen JO,Flores MT,et al.Guidelines for the management of traumatic dental injuries:3.injuries in the primary dentition.Pediatr Dent,2016,38(6):377-385.
[8]Committee On Pediatric Emergency Medicine COIV.Management of pediatric trauma.Pediatrics,2016,138(2).
[9]de Caen AR,Berg MD,Chameides L,et al.Part 12:pediatric advanced life support:2015american heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.Circulation,2015,132(18Suppl 2):S526-S542.
[10]Verstraete M,Cros P,Gouin M,et al.Update on the management of acute viral bronchiolitis:proposed guidelines of Grand Ouest University Hospitals.Arch Pediatr,2014,21(1):53-62.
[11]Mintegi S,Clerigue N,Tipo Vincenzo,et al.Pediatric cyanide poisoning by fire smoke inhalation:a European expert consensus.Paediatric Emergency Care,2013,29(11):1234-1240.
[12]Do T.Implementing the IOM recommendations for improving pediatric emergency care in your emergency department:start from where you are!.J Emerg Nurs,2011,4(37):404-407.
[13]Kissoon N,Orr RA,Carcillo JA.Updated american college of critical care medicinepediatric advanced life support guidelines for management of pediatric and neonatal septic shock:relevance to the emergency care clinician.Pediatr Emerg Care,2010,26(11):867-869.
[14]World Health Organization.Paediatric emergency triage,assessment and treatment:care of critically-ill children(Updates Guideline).Geneva:World Health Organization,2016.
[15]Expert Committee On Pediatric Epilepsy IAOP.Guidelines for diagnosis and management of childhood epilepsy.Indian Pediatr,2009,46(8):681-698.
[16]Campbell RL,Li JT,Nicklas RA,et al.Emergency department diagnosis and treatment of anaphylaxis:a practice parameter.Ann Allergy Asthma Immunol,2014,113(6):599-608.
[17]周桂侠.急救流程培训在妇科新护士带教中的应用.中华护理教育,2012(10):472-473.Zhou GX.The application of emergency care process training in new gynecological nurse.Chinese Journal of Nursing Education,2012(10):472-473.
[18]刘金金.ABC定位培训模式在提高护士对重点病种急救流程认知中的应用.齐鲁护理杂志,2015(4):110-111.Liu JJ.Application of ABC location training mo de in improving nurses'acknowledge of emergency management process of the key diseases.J Qilu Nurs,2015(4):110-111.
[19]冯小华,姬宇,马晓敏,等.运用定位抢救模式提高急诊护士儿科急救能力的体会.中国伤残医学,2014(2):280-281.Feng XH,Ji Y,Ma XM,et al.To improve pediatric emergency nurses'emergency care ability by use of location rescue mode.Chinese Journal of Trauma and Disability Medicine,2014(2):280-281.
[20]Sandhu N,Eppich W,Mikrogianakis A,et al.Post resuscitation debriefing in the pediatric emergency depar tment:a national needs assessment.CJEM,2014,16(5):383-392.
[21]Callegaro S,Titomanlio L,Donega S,et al.Implementation of a febrile seizure guideline in two pediatric emergency departments.Pediatr Neurol,2009,40(2):78-83.
[22]马文萃.PDCA在产科优质护理服务中的应用.护理实践与研究,2014(3):45-46.Ma WC.Application of PDCA in high quality nursing service in obstetrics.Nursing Practice and Research,2014(3):45-46.
[23]杨立文,王玉生.PDCA循环管理模式在急诊护理管理中的应用.实用临床护理学电子杂志,2017(3):163-166.Yang LW,Wang YS.Application of PDCAmanagement mode in emergency nursing management.Journal of Clinic Nursing's Practicality,2017(3):163-166.
[24]孙英莉.PDCA模式对急诊科护理质量及抢救有效率的影响分析.中国医学工程,2015(1):127.Sun YL.Impact of PDCA mode on emergency nursing quality and rescue efficiency.China Medical Engineering,2015(1):127.
[25]吴妙桓,郭剑虹,郑瑞琪,等.PDCA循环管理法在急诊科低年资护士培训中的应用.中国医学创新,2013(18):81-84.Wu MH,Guo JH,Zheng RQ,et al.Application of PDCA circulation mode in training of new nurse in emergency department.Medical Innovation of China,2013(18):81-84.
[26]郑军,贾冬云,向红.PDCA管理方法在提高呼吸科危重症患者抢救成功率中的作用.护理实践与研究,2014(8):115-117.Zheng J,Jia DY,Xiang H.Application of PDCAmethod in improving rescue efficiency in RICU.Nursing Practice and Research,2014(8):115-117.