ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2024, Vol. 5 ›› Issue (4): 305-311.doi: 10.3761/j.issn.2096-7446.2024.04.003

• 危重患儿护理专题 • 上一篇    下一篇

转运标准化流程管理在儿科体外膜肺氧合快速反应团队中的应用

黄雅丽, 蔡淑红, 王谢磊, 郑义熔   

  1. 350001 福州市 福建省儿童医院/上海儿童医学中心福建医院/福建医科大学妇儿临床医学院心脏外科重症监护室
  • 收稿日期:2023-06-28 出版日期:2024-04-10 发布日期:2024-04-15
  • 作者简介:黄雅丽：女,本科（硕士在读）,主管护师,E-mail：251682124@qq.com

Application of standardized transport process management in pediatric extracorporeal membrane oxygenation rapid response team

HUANG Yali, CAI Shuhong, WANG Xielei, ZHENG Yirong   

  • Received:2023-06-28 Online:2024-04-10 Published:2024-04-15

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摘要： 目的 构建儿科体外膜肺氧合（extracorporeal membrane oxygenation,ECMO）快速反应团队转运标准化流程管理方案并分析其应用效果。方法 通过文献检索、专家函询构建ECMO快速反应团队转运标准化流程管理方案。连续收集2021年7月—2022年12月福建省某儿童医院收治的19例行ECMO治疗的新生儿资料,其中2022年1月—12月基于ECMO快速反应团队开展ECMO治疗的11例患儿为试验组,采用ECMO快速反应团队转运标准化流程;2021年7月—12月开展常规ECMO治疗的8例患儿作为对照组,采用常规ECMO救治流程。比较两组团队准备时间、置管时间、急救技术、专业知识、抢救秩序、配合抢救速度、应急主动性、急救综合满意度,以及两组患儿神经系统并发症和住院期间死亡例数的差异。结果 试验组的团队准备时间（33.10±6.06） min、置管时间（47.45±6.73） min均较对照组明显缩短,团队成员的急救综合满意度较干预前明显提高,差异均具有统计学意义（P<0.001）;两组各出现2例神经系统并发症,试验组2例患儿在住院期间死亡。结论 儿科ECMO快速反应团队转运标准化流程管理可以缩短ECMO救治启动时间,提高团队成员急救综合满意度,对急危重症患儿的救治具有积极作用。

关键词: 护理标准, 流程管理, 医院快速反应小组, 体外膜氧合作用, 危重病护理

Abstract: Objective A standardized transport process management for pediatric extracorporeal membrane oxygenation（ECMO）-rapid response team（RRT） was constructed and applied,and its application effect was analyzed. Methods ECMO-RRT standardized transport process management was constructed through literature search,expert consultation. We continuously selected 19 patients who applied ECMO treatment in a children hospital in Fujian Province from July 2021 to December 2022 as the study subjects,including 11 cases admitted in January to December 2022 as the experimental group,and 8 cases admitted from July 2021 to December 2021 as the control group. The experimental group was implemented by a ECMO-RRT standardized transport process management,and the control group was implemented by a routine ECMO treatment process. The differences in team preparation time,time of catherterization,first aid technique,professional knowledge,rescue order,cooperative rescue speed and emergency initiative,rescue comprehensive satisfaction,the occurrence of neurological complications and the number of deaths during hospitali were compared between two groups. Results Compared with the control group,the team preparation time（33.10±6.06） minutes,the time of catherterization（47.45±6.73） minutes were significantly shortened,and comprehensive satisfaction in the experimental group increased significantly. The differences were statistically significant（P<0.001）. There were 2 cases of neurological complications in each of the two groups,and 2 cases in the experimental group died during hospitalization. Conclusion The application of the ECMO-RRT standardized transport process management for pediatric ECMO patients can shorten the time of initiation of ECMO treatment and improve the overall satisfaction of team members and has a positive effect on the treatment of critically ill pediatric patients.

Key words: Standard of Care, Process Management, Hospital Rapid Response Team, Extracorporeal Membrane Oxygenation, Critical Care Nursing