广西边境地区县级综合医院急诊科应对突发公共卫生事件能力状况调查
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摘要
目的了解广西边境地区县级综合医院急诊科突发公共卫生事件应对能力状况。方法以普查方法对广西边境地区22家县级综合医院进行问卷调查,内容包括急诊科一般情况、人力资源配置状况、应对突发公共卫生事件制度机制、急救医疗设备等。结果 22家县级综合医院急诊科拥有开放床位总数281张,占医院床位总数的3.7%(281/7 587)。急诊科医师学历以本科为主,占54.7%;职称以中级为主,占50.9%。护士学历以大专为主,占61.8%;职称以初级及以下为主,占69.9%。共有20家医院报告能增加应急床位1 360张,占22家医院床位总数的17.9%;其中有13家医院报告急诊科有能力增加应急床位共59张,占应急床位总数的4.3%(59/1 360)。22家县级综合医院均配备救护车,共69辆,只有2家医院分别配置了1辆负压救护车。医疗急救设备中,心肺复苏机、喉罩和心脏泵的拥有率较低;便携式呼吸机、心脏除颤器、心电图机、心肺复苏机、气管插管镜、喉罩、心脏泵、便携式B超和洗胃机等设备拥有量较少。结论广西边境地区县级综合医院急诊科医护人员专业职称偏低;急诊科床位编制偏少,卫生应急床位和应急人力储备不足;急救设备配置较少,负压救护车数量严重不足。广西边境地区县级综合医院急诊科应对突发公共卫生事件能力有待提高。
Objective To understand the current situation of public health emergency response ability in the emergency department of county general hospitals in the border areas of Guangxi. Methods Questionnaire survey was conducted among emergency departments of 22 county hospitals in border areas of Guangxi, the data about general situation, human resources allocation, response ability to public health emergencies, institutional mechanisms, emergency medical equipment etc. were collected and analyzed. Results The emergency departments of 22 county hospitals had 281 open beds, which accounted for 3.7%(281/7 587) of the total beds in the hospitals. The education degree of the first aid physicians was mainly bachelor(54.7%), the title was mainly intermediate(50.9%);the degree of nurses was mainly in junior college(61.8%); the titles were mainly junior and intermediate(69.9%).Twenty hospitals reported that they can provide 1390 temporary emergency beds, accounting for 17.9% of the total beds in 22 hospitals; Thirteen hospitals reported that the emergency departmensts were able to provide 59 emergency beds, accounting for 4.3% of the total emergency beds(59/1 360). All 22 hospitals were equipped with ambulances, and the total numbers of the ambulances were69, while only two hospitals were equipped with negative pressure ambulance. The hospitals had insufficient emergency medical equipments like cardiopulmonary resuscitation, laryngeal mask and heart pump and small amount of portable ventilator and heart defibrillator, ECG, CPR, tracheal intubation, mirror heart pump, portable ultrasound,gastric lavage machine. Conclusions The medical staffs in the emergency department of the general hospitals in the border area of Guangxi are not equipped with sufficient skills, the beds in emergency department are poorly prepared, the emergency beds and emergency manpower reservation are insufficient, the emergency equipments have a shortage, and the negative pressure ambulances are seriously inadequate. The public health emergency response ability of emergency departments in county general hospitals in border areas of Guangxi needs to be further strengthened and improved.
Objective To understand the current situation of public health emergency response ability in the emergency department of county general hospitals in the border areas of Guangxi. Methods Questionnaire survey was conducted among emergency departments of 22 county hospitals in border areas of Guangxi, the data about general situation, human resources allocation, response ability to public health emergencies, institutional mechanisms, emergency medical equipment etc. were collected and analyzed. Results The emergency departments of 22 county hospitals had 281 open beds, which accounted for 3.7%(281/7 587) of the total beds in the hospitals. The education degree of the first aid physicians was mainly bachelor(54.7%), the title was mainly intermediate(50.9%);the degree of nurses was mainly in junior college(61.8%); the titles were mainly junior and intermediate(69.9%).Twenty hospitals reported that they can provide 1390 temporary emergency beds, accounting for 17.9% of the total beds in 22 hospitals; Thirteen hospitals reported that the emergency departmensts were able to provide 59 emergency beds, accounting for 4.3% of the total emergency beds(59/1 360). All 22 hospitals were equipped with ambulances, and the total numbers of the ambulances were69, while only two hospitals were equipped with negative pressure ambulance. The hospitals had insufficient emergency medical equipments like cardiopulmonary resuscitation, laryngeal mask and heart pump and small amount of portable ventilator and heart defibrillator, ECG, CPR, tracheal intubation, mirror heart pump, portable ultrasound,gastric lavage machine. Conclusions The medical staffs in the emergency department of the general hospitals in the border area of Guangxi are not equipped with sufficient skills, the beds in emergency department are poorly prepared, the emergency beds and emergency manpower reservation are insufficient, the emergency equipments have a shortage, and the negative pressure ambulances are seriously inadequate. The public health emergency response ability of emergency departments in county general hospitals in border areas of Guangxi needs to be further strengthened and improved.
引文
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[4]邢玉华,刘锦生.基层医院急诊科建设的探讨[J].中国卫生事业管理,2011,增刊(S1):53-54.
[5]王亮,刘志峰,彭相文,等.黑龙江省20家三级综合医院急诊科现状调查与分析[J].中国医院管理,2015,35(12):68-69.
[6]王畅,王声湧,代金芳,等.广东省18家医院急诊科医护人员离职意愿及其影响因素调查[J].中国职业医学,2011,38(4):287-290.
[7]陈虹.军队数字化医院突发公共卫生事件应对能力现状评价研究[D].第三军医大学博士学位论文,2011.
[8]阎家骏,孙亚玲.床位统一管理,跨科收治病人[J].中国医院,2010,14(3):71-72.
[9]张慧.北京市二级以上医院突发公共卫生事件[D].中国协和医科大学博士学位论文,2006.
[10]赵琦.基层突发公共卫生事件应急体系应对能力评估工具的开发、应用与评估模型的探索性研究[D].复旦大学博士学位论文,2009.
[11]张宇杰,陈兵,林才经,等.福建省救护车使用情况及车辆配置调查[J].中华灾害救援医学,2016,4(7):369-371.
[12]孙景工,刘亚军,徐新喜,等.传染病员救护车负压净化系统研究[J].军事医学科学院院刊,2004,28(4):361-363.