危重症患儿院际转运安全管理的研究进展

doi:10.3761/j.issn.2096-7446.2022.04.017

摘要/Abstract

摘要： 院际转运是医院间进行的转运,以进行更高级别的治疗与护理。虽然国内外已有指南或专家共识指导危重症患儿的院际转运,但安全性问题仍普遍存在。该文综述了危重症患儿院际转运安全性现况、影响因素、风险评估工具及转运安全提升策略,以期为优化儿科领域的院际转运体系、提升转运质量提供参考。

关键词: 院际转运, 安全管理, 危重病, 儿童, 文献综述专题

Abstract: Interhospital transfer was transfer between hospitals for a higher level of treatment and care. Although there were domestic and foreign guidelines or expert consensus to guide the interhospital transfer of critically ill children,safety issues still existed. This paper reviewed the current situation,influencing factors,risk assessment tools and strategies for improving the safety of interhospital transfer of critically ill children,in order to provide a reference for optimizing the interhospital transfer system in the field of pediatrics in China and improving the quality of transfer.

Key words: Interhospital Transportation, Safety Management, Critical Illness, Child, Review Literature as Topic

周红琴, 夏姗姗, 诸纪华, 陈秀萍, 楼晓芳. 危重症患儿院际转运安全管理的研究进展[J]. 中华急危重症护理杂志, 2022, 3(4): 372-376.

ZHOU Hongqin, XIA Shanshan, ZHU Jihua, CHEN Xiuping, LOU Xiaofang. Research progress on safety management of interhospital transfer of critically ill children[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(4): 372-376.

参考文献

[1] Lerner EB,Studnek JR,Fumo N,et al.Multicenter analysis of transport destinations for pediatric prehospital patients[J]. Acad Emerg Med,2019,26(5):510-516.
[2] Romito J,Alexander SN.Guidelines for air & ground transport of neonatal and pediatric patients manual[M]. 4th Ed. American Academy of Pediatrics,2015.
[3] 中华医学会急诊医学分会儿科学组,中华医学会儿科学分会急救学组,中国医师协会儿童重症医师分会. 重症儿童院际三级转诊专家建议[J]. 中国小儿急救医学,2015,22(11):744-746.
Pediatrics Group of Emergency Medicine Branch of Chinese Medical Association,Emergency Medicine Group of Pediatrics Branch of Chinese Medical Association,Pediatric Intensive Physician Branch of Chinese Medical Doctor Association. Expert advice on interhospital tertiary referral of critically ill children[J]. Chin Pediatr Emerg Med,2015,22(11):744-746.
[4] Foronda C,VanGraafeiland B,Quon R,et al. Handover and trans-port of critically ill children:an integrative review[J]. Int J Nurs Stud,2016,62:207-225.
[5] Singh JM,Gunz AC,Dhanani S,et al.Frequency,composition,and predictors of in-transit critical events during pediatric critical care transport[J]. Pediatr Crit Care Med,2016,17(10):984-991.
[6] Ramnarayan P,Dimitriades K,Freeburn L,et al.Interhospital transport of Ritically ill children to PICUs in the United Kingdom and Republic of Ireland:analysis of an international dataset[J]. Pediatr Crit Care Med,2018,19(6):e300-e311.
[7] Chaichotjinda K,Chantra M,Pandee U.Assessment of interhos-pital transport care for pediatric patients[J]. Clin Exp Pediatr,2020,63(5):184-188.
[8] 任路,朱翠平,吴小惠,等. 院际转运危重患儿死亡病例分析[J]. 中国小儿急救医学,2015,22(3):169-172.
Ren L,Zhu CP,Wu XH,et al.Death analysis of critically ill children with interhospital transportation[J]. Chin Pediatr Emerg Med,2015,22(3):169-172.
[9] 胥志跃,肖政辉,仇君,等. 湖南省儿童医院院际转诊危重患儿不良事件分析[J]. 中国小儿急救医学,2016,23(5):329-332.
Xu ZY,Xiao ZH,Qiu J,et al.Adverse events of inter-hospital transport of critical pediatric patient in Hunan Children's Hospital[J]. Chin Pediatr Emerg Med,2016,23(5):329-332.
[10] Ramnarayan P,Intikhab Z,Spenceley N,et al.Inter-hospital tran-sport of the child with critical cardiac disease[J]. Cardiol Young, 2017,27(S6):S40-S46.
[11] Harvey M,Edmunds S,Ghose A.Transporting critically ill children[J]. Anaesth Intensive Care Med,2020,21(12):641-648.
[12] American Academy of Pediatrics Committee on Pediatric Emer-gency Medicine,American College of Rmergency Physicians Pediatric Emergency Medicine Committee,Emergency Nurses Association Pediatric Committee. Handoffs:transitions of care for children in the emergency department[J]. Pediatrics,2016,138(5):e20162680.
[13] Petrillo-Albarano T,Stockwell J,Leong T,et al.The use of a modified pediatric early warning score to assess stability of pediatric patients during transport[J]. Pediatr Emerg Care,2012,28(9):878-882.
[14] Kandil SB,Schmenk Sanford HA,Northrup V,et al.Transport disposition using the Transport Risk Assessment in Pediatrics (TRAP) score[J]. Prehosp Emerg Care,2012,16(3):366-373.
[15] Holt T,Parker K,Shaw A,et al.Serial clinical scoring to assess transported pediatric patients[J]. Pediatr Emerg Care,2021, 37(12):e1600-e1602.
[16] Shinozaki RM,Schwingshackl A,Srivastava N,et al.Pediatric interfacility transport effects on mortality and length of stay[J]. World J Pediatr,2021,17(4):400-408.
[17] Gilpin D,Hancock S.Referral and transfer of the critically ill child[J]. BJA Educ,2015,16(8):253-257.
[18] Breathnach M,Lane P.Paediatric inter-hospital transportation:a clinical governance project[J]. Br J Nurs,2017,26(13):758-761.
[19] Gee SW,Holt PL,Stoner MJ.Safe interfacility transport of pe-diatric patients:medical control training,an interdisciplinary approach[J]. Air Med J,2018,37(2):120-123.
[20] Peterson E,Porter M,Calhoun A.Mixed-reality simulation for a pediatric transport team:a pilot study[J]. Air Med J,2020, 39(3):173-177.
[21] Wilson D,Kochar A,Whyte-Lewis A,et al.Evaluation of situation,background,assessment,recommendation tool during neonatal and pediatric interfacility transport[J]. Air Med J,2017,36(4):182-187.
[22] Sochet AA,Siems A,Ye G,et al.Standardization of postoperative transitions of care to the pediatric intensive care unit en-hances efficiency and handover comprehensiveness[J]. Pediatr Qual Saf,2016,1(2):e004.
[23] Sochet AA,Ryan KS,Miller W,et al.A longitudinal and sustainability assessment of pediatric interfacility transport handover standardization[J]. Pediatr Qual Saf,2018,3(6):e118.
[24] Patel S,Hertzog JH,Penfil S,et al.A prospective pilot study of the use of telemedicine during pediatric transport[J]. Pediatr Emerg Care,2015,31(9):611-615.
[25] Curfman A,Groenendyk J,Markham C,et al.Implementation of telemedicine in pediatric and neonatal transport[J]. Air Med J,2020,39(4):271-275.
[26] Gunz AC,McNally JD,Whyte H,et al. Defining significant events for neonatal and pediatric transport:results of a combined Delphi and consensus meeting process[J]. J Pediatr In-tensive Care,2017,6(3):165-175.
[27] Schwartz HP,Bigham MT,Schoettker PJ,et al.Quality metrics in neonatal and pediatric critical care transport:a national Delphi project[J]. Pediatr Crit Care Med,2015,16(8):711-717.