改良早期预警评分表应用于危重新生儿院内转运的效果探讨
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摘要
目的:评价改良早期预警评分表在危重新生儿院内转运中的应用效果。方法:选取由产房和手术室转运至新生儿监护病房的120例危重新生儿为研究对象,2017年7-12月的60例新生儿纳入对照组,2018年1-6月的60例新生儿纳入实验组。对照组采用常规方法转运,实验组结合改良早期预警评分表制定转运分级标准和流程,分为Ⅰ、Ⅱ、Ⅲ级,分级配备转运人员和装备,加强转运人员的培训和演练,质量控制小组实施专门管理。结果:实验组转运时间少于对照组,转运不良事件和新生儿不良结局发生率低于对照组,差异均有统计学意义(P<0.05)。结论:运用改良早期预警评分表指导危重新生儿院内转运,可缩短转运时间,减少不良事件的发生,保证危重新生儿转运安全,改善新生儿结局。
Objective: To evaluate the effect of modified Early Warning Score Table on in-hospital transfer of critically ill newborns. Methods: Historically controlled study method was performed. Totally 60 newborns were included in the control group from July to December 2017, while 60 newborns were included in the test group from January to June 2018.The control group was transferred with existing methods, and the test group were transferred with new methods based on the results of the modified Early Warning Score Table. Results: The transit time of the experimental group was shorter than that of the control group. The incidence of adverse events and neonatal adverse outcomes were lower than that of the control group, and the differences were statistically significant respectively(P<0.05). Conclusion: The modified Early Warning Score Table is used to guide the in-hospital transfer of critically ill newborns, shortening the transit time, reducing the occurrence of adverse events, ensuring the safety of critically ill newborns and improving the outcome of neonates.
Objective: To evaluate the effect of modified Early Warning Score Table on in-hospital transfer of critically ill newborns. Methods: Historically controlled study method was performed. Totally 60 newborns were included in the control group from July to December 2017, while 60 newborns were included in the test group from January to June 2018.The control group was transferred with existing methods, and the test group were transferred with new methods based on the results of the modified Early Warning Score Table. Results: The transit time of the experimental group was shorter than that of the control group. The incidence of adverse events and neonatal adverse outcomes were lower than that of the control group, and the differences were statistically significant respectively(P<0.05). Conclusion: The modified Early Warning Score Table is used to guide the in-hospital transfer of critically ill newborns, shortening the transit time, reducing the occurrence of adverse events, ensuring the safety of critically ill newborns and improving the outcome of neonates.
引文
[1]徐卫容,李磊,林洪波,等.品管圈在急诊危重患者安全转运中应用的效果评价.中国实用护理杂志,2015,31(9):665-666.Xu WR,Li L,Lin HB,et al.Evaluation of the effect of quality control circle on safe transport of critically ill patients in emergency department.Chinese Journal of Practical Nursing,2015,31(9):665-666.
[2]迟春昕,谭宝琴,侯海萍,等.高危新生儿预警评分系统(MEWS)的研究与应用.中华现代护理杂志,2016,22(23):3354-3357.Chi CX,Tan BQ,Hou HP,et al.Research and application of high risk newborn early warning scoring system(MEWS).Chinese Journal of Modern Nursing,2016,22(23):3354-3357.
[3]万林,施素华,黄榕,等.预警分级管理在院内转运中的应用及效果评价.中华护理杂志,2017,52(1):59-62.Wan L,Shi SH,Huang R,et al.Application and effect evaluation of early warning grading management in hospital transport.Chinese Journal of Nursing,2017,52(1):59-62.
[4]刘士方,朱月兰,樊小鹏,等.改良早期预警评分系统在急诊危重患者院内转运中的应用.解放军护理杂志,2016,33(8):68-70.Liu SF,Zhu YL,Fan XP,et al.Application of improved early warning scoring system in inhospital transport of critically ill patients in emergency department.Nurs J Chin PLA,2016,33(8):68-70.
[5]侯海萍,谭宝琴,梁妙娟,等.高危新生儿预警评分用于危重新生儿病情评估的敏感度与特异性研究.临床护理杂志,2017,16(6):2-4.Hou HP,Tan BQ,Liang MJ,et al.Sensitivity and specificity of high-risk neonatal early warning scores for critical neonatal disease assessment.Journal of Clinical Nursing,2017,16(6):2-4.
[6]Dragovich D,Tamburlini G,Alisjahbana A,et al.Thermal control of the newborn:knowledge and practice of health professional in seven countries.Acta Paediatrica,2010,86(6):645-650.
[7]Petrilloalbarano T,Stockwell J,Leong T,et al.The use of a modified pediatric early warning score to assess stability of pediatric patients during transport.Pediatric Emergency Care,2012,28(9):878-882.
[8]宋国维.积极推广应用小儿危重病例评分法.中华儿科杂志,2003,41(8):561-562.Song GW.Actively promote the application of pediatric critical cases scoring method.Chinese Journal of Pediatrics,2003,41(8):561-562.
[9]杨静雯,冯志仙.早期预警评分的研究进展.中国护理管理,2015,15(5):629-632.Yang JW,Feng ZX.Research progress of early warning score.Chinese Journal of Nursing Management,2015,15(5):629-632.
[10]黄晓波,韦琴.新生儿早期预警评分系统的应用研究进展.中国护理管理,2017,17(4):502-506.Huang XB,Wei Q.Advances in the application of early warning system for newborns.Chinese Nursing Management,2017,17(4):502-506.
[11]陈岚,郑寒,叶向红,等.急诊患者院内转运的风险与影响因素研究.中国护理管理,2018,18(9):1249-1252.Chen L,Zheng H,Ye XH,et al.Study on risk and influencing factors of hospitalized transport in emergency patients.Chinese Nursing Management,2018,18(9):1249-1252.
[12]??ld?r E,Bulut M,Akal?n H,et al.Evaluation of the modified MEDS,MEWS score and Charlson comorbidity index in patients with community acquired sepsis in the emergency department.Internal&Emergency Medicine,2013,8(3):255-260.
[13]Kue R,Brown P,Ness C,et al.Adverse clinical events during intra-hospital transport by a specialized team:a preliminary report.Am J Crit Care,2011,20(2):153-161.
[14]赵立民,文素芳,容桂荣,等.多学科合作的流程管理在脑科危重患者院间转运中的应用效果分析.中国护理管理,2017,17(7):981-986.Zhao LM,Wen SF,Rong GR,et al.Analysis of application effect of multidisciplinary cooperation process management in inter-transit of critically ill patients with brain.Chinese Nursing Management,2017,17(7):981-986.
[15]黄晓波,韦琴,杨朝霞,等.增加出生胎龄及出生体重两项指标对新生儿早期预警评分预测早产儿病情恶化的能力的影响.广西医学,2018(8):882-885.Huang XB,Wei Q,Yang ZX,et al.Effect of increasing fetal gestational age and birth weight on the ability of neonatal early warning score to predict the deterioration of premature infants.Guangxi Medical Journal,2018(8):882-885.
[16]孔祥永,封志纯.《中国新生儿转运指南(2013)》解读.发育医学电子杂志,2013,1(2):70-73.Kong XY,Feng ZC."Chinese Newborn Transit Guide(2013)"Interpretation.Developmental Medicine E-Magazine,2013,1(2):70-73.
[17]王斌,刘婷.急诊重度颅脑损伤患者院内转运中的无缝隙交接.中华护理杂志,2015,50(2):246-247.Wang B,Liu T.Seamless handover in hospital inpatients with severe craniocerebral injury in emergency department.Chinese Journal of Nursing,2015,50(2):246-247.
[2]迟春昕,谭宝琴,侯海萍,等.高危新生儿预警评分系统(MEWS)的研究与应用.中华现代护理杂志,2016,22(23):3354-3357.Chi CX,Tan BQ,Hou HP,et al.Research and application of high risk newborn early warning scoring system(MEWS).Chinese Journal of Modern Nursing,2016,22(23):3354-3357.
[3]万林,施素华,黄榕,等.预警分级管理在院内转运中的应用及效果评价.中华护理杂志,2017,52(1):59-62.Wan L,Shi SH,Huang R,et al.Application and effect evaluation of early warning grading management in hospital transport.Chinese Journal of Nursing,2017,52(1):59-62.
[4]刘士方,朱月兰,樊小鹏,等.改良早期预警评分系统在急诊危重患者院内转运中的应用.解放军护理杂志,2016,33(8):68-70.Liu SF,Zhu YL,Fan XP,et al.Application of improved early warning scoring system in inhospital transport of critically ill patients in emergency department.Nurs J Chin PLA,2016,33(8):68-70.
[5]侯海萍,谭宝琴,梁妙娟,等.高危新生儿预警评分用于危重新生儿病情评估的敏感度与特异性研究.临床护理杂志,2017,16(6):2-4.Hou HP,Tan BQ,Liang MJ,et al.Sensitivity and specificity of high-risk neonatal early warning scores for critical neonatal disease assessment.Journal of Clinical Nursing,2017,16(6):2-4.
[6]Dragovich D,Tamburlini G,Alisjahbana A,et al.Thermal control of the newborn:knowledge and practice of health professional in seven countries.Acta Paediatrica,2010,86(6):645-650.
[7]Petrilloalbarano T,Stockwell J,Leong T,et al.The use of a modified pediatric early warning score to assess stability of pediatric patients during transport.Pediatric Emergency Care,2012,28(9):878-882.
[8]宋国维.积极推广应用小儿危重病例评分法.中华儿科杂志,2003,41(8):561-562.Song GW.Actively promote the application of pediatric critical cases scoring method.Chinese Journal of Pediatrics,2003,41(8):561-562.
[9]杨静雯,冯志仙.早期预警评分的研究进展.中国护理管理,2015,15(5):629-632.Yang JW,Feng ZX.Research progress of early warning score.Chinese Journal of Nursing Management,2015,15(5):629-632.
[10]黄晓波,韦琴.新生儿早期预警评分系统的应用研究进展.中国护理管理,2017,17(4):502-506.Huang XB,Wei Q.Advances in the application of early warning system for newborns.Chinese Nursing Management,2017,17(4):502-506.
[11]陈岚,郑寒,叶向红,等.急诊患者院内转运的风险与影响因素研究.中国护理管理,2018,18(9):1249-1252.Chen L,Zheng H,Ye XH,et al.Study on risk and influencing factors of hospitalized transport in emergency patients.Chinese Nursing Management,2018,18(9):1249-1252.
[12]??ld?r E,Bulut M,Akal?n H,et al.Evaluation of the modified MEDS,MEWS score and Charlson comorbidity index in patients with community acquired sepsis in the emergency department.Internal&Emergency Medicine,2013,8(3):255-260.
[13]Kue R,Brown P,Ness C,et al.Adverse clinical events during intra-hospital transport by a specialized team:a preliminary report.Am J Crit Care,2011,20(2):153-161.
[14]赵立民,文素芳,容桂荣,等.多学科合作的流程管理在脑科危重患者院间转运中的应用效果分析.中国护理管理,2017,17(7):981-986.Zhao LM,Wen SF,Rong GR,et al.Analysis of application effect of multidisciplinary cooperation process management in inter-transit of critically ill patients with brain.Chinese Nursing Management,2017,17(7):981-986.
[15]黄晓波,韦琴,杨朝霞,等.增加出生胎龄及出生体重两项指标对新生儿早期预警评分预测早产儿病情恶化的能力的影响.广西医学,2018(8):882-885.Huang XB,Wei Q,Yang ZX,et al.Effect of increasing fetal gestational age and birth weight on the ability of neonatal early warning score to predict the deterioration of premature infants.Guangxi Medical Journal,2018(8):882-885.
[16]孔祥永,封志纯.《中国新生儿转运指南(2013)》解读.发育医学电子杂志,2013,1(2):70-73.Kong XY,Feng ZC."Chinese Newborn Transit Guide(2013)"Interpretation.Developmental Medicine E-Magazine,2013,1(2):70-73.
[17]王斌,刘婷.急诊重度颅脑损伤患者院内转运中的无缝隙交接.中华护理杂志,2015,50(2):246-247.Wang B,Liu T.Seamless handover in hospital inpatients with severe craniocerebral injury in emergency department.Chinese Journal of Nursing,2015,50(2):246-247.