急诊严重创伤患者院前急救至院内康复全流程护理方案的构建及适用性分析

doi:10.3761/j.issn.2096-7446.2025.03.003

摘要/Abstract

摘要：

目的基于时机理论构建急诊严重创伤患者院前急救至院内康复阶段全流程的护理方案，为临床护理工作提供参考。方法以时机理论为指导，在文献研究、半结构式访谈的基础上拟订干预方案初稿。2024年3月—4月对北京市、湖南省、广西省、广东省、吉林省、黑龙江省6个省（市）的18名创伤外科、急诊、危重症医学科的医疗和护理专家进行两轮德尔菲专家函询，形成方案终稿。结果两轮专家函询问卷的有效回收率分别为94.73%和100%，专家权威系数分别为0.919、0.917，两轮函询条目重要性和可操作性的肯德尔和谐系数分别为0.100、0.091和0.072、0.073，均P<0.05。最终形成的护理方案包含5个一级条目、17个二级条目、72个三级条目。结论基于时机理论构建的急诊严重创伤患者院前急救至院内康复全流程护理方案具有科学性、可靠性、针对性和连续性，可满足患者的护理需求，并为提高严重创伤患者的护理质量和提升患者的救治效果提供参考。

关键词: 严重创伤, 时机理论, 德尔菲法, 急诊, 护理

Abstract:

Objective To construct a whole-process nursing program from pre-hospital first aid to in-hospital rehabilitation for emergency severe trauma patients based on the theory of ‘Timing It Right’，and to provide reference for clinical nursing work. Methods Guided by the theory of ‘Timing It Right’，the first draft of the intervention plan was drawn up on the basis of literature research and semi-structured interviews. From March to April 2024，18 medical and nursing experts from Hunan，Guangxi，Guangdong，Jilin，Heilongjiang Province and Beijing were consulted by Delphi experts for two rounds，and the final draft of the program was formed. Results The effective recovery rates of the two rounds of consultation were 94.73% and 100% respectively，and the expert authority coefficients were 0.919 and 0.917 respectively. The Kendall harmony coefficients of the importance and operability of the two rounds of consultation were 0.100，0.091，and 0.072，0.073 respectively，all P<0.05. The final intervention program includes 5 first-level items，17 second-level items and 72 third-level items. Conclusion The whole-process nursing program for emergency severe trauma patients based on the theory of ‘Timing It Right’ is scientific，reliable，targeted and continuous，which can meet the nursing needs of patients，and provide reference for improving the nursing quality of patients with severe trauma and improving the treatment effects of patients.

Key words: Severe Trauma, Timing It Right, Delphi Method, Emergency Treatment, Nursing Care

何沙沙, 王志敏, 蒋丹丹, 刘静, 谭彩霞, 邹立成. 急诊严重创伤患者院前急救至院内康复全流程护理方案的构建及适用性分析[J]. 中华急危重症护理杂志, 2025, 6(3): 275-282.

HE Shasha, WANG Zhimin, JIANG Dandan, LIU Jing, TAN Caixia, ZOU Licheng. Construction and applicability analysis of whole-process nursing plan from pre-hospital first aid to in-hospital rehabilitation for emergency severe trauma patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 275-282.

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