三级甲等医院急诊科体外心肺复苏团队标准化运行困境的质性研究

doi:10.3761/j.issn.2096-7446.2026.08.006

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (8): 937-942.doi: 10.3761/j.issn.2096-7446.2026.08.006

三级甲等医院急诊科体外心肺复苏团队标准化运行困境的质性研究

顾尧(), 季学丽^*(), 周正, 黄夕华, 陈旭锋

南京医科大学第一附属医院急诊与危重症医学科南京市 210009

收稿日期:2025-12-28 出版日期:2026-08-10 发布日期:2026-08-04
通讯作者: *季学丽，E-mail：365785102@qq.com
作者简介:顾尧：男，本科，护师，E-mail：1459023014@qq.com
作者贡献声明
顾尧：研究设计、资料收集、资料分析、论文撰写；季学丽：研究选题指导、研究设计、论文修订；周正：研究选题、资料分析；黄夕华：资料分析、论文撰写；陈旭锋：研究指导、论文审阅
基金资助:
江苏省科教能力提升工程-江苏省医学重点学科(ZDXK202213)

Barriers of standardized operation of emergency department extracorporeal cardiopulmonary resuscitation team in a tertiary hospital：a qualitative study

GU Yao(), JI Xueli^*(), ZHOU Zheng, HUANG Xihua, CHEN Xufeng

Department of Emergency， the First Affiliated Hospital of Nanjing Medical University， Nanjing 210009， China

Received:2025-12-28 Online:2026-08-10 Published:2026-08-04
Contact: *JI Xueli，E-mail：365785102@qq.com
Supported by:
Jiangsu Province Capacity Enhancement Project for Science，Education and Health—Jiangsu Provincial Key Medical Discipline(ZDXK202213)

摘要/Abstract

摘要：

目的探讨三级甲等医院急诊科体外心肺复苏团队标准化运行的困境，为完善标准化运行策略提供参考。方法采用现象学研究方法，于2025年10月—12月采用目的抽样法并遵循最大差异取样原则，选取江苏省某三级甲等医院急诊科参与实施体外心肺复苏术的18名医护人员进行半结构式访谈，采用Colaizzi 7步分析法分析资料。结果提炼出4个主题、11个子主题：高度时间压力与复杂情境下标准化流程难以完全落地；人力资源长期紧张，医护人员承受高负荷；培训体系重操作、轻系统，能力结构失衡；高风险、高成本决策情境下医护人员心理压力突出。结论三级甲等医院急诊体外心肺复苏团队标准化运行存在情境适配不足、多部门协作衔接不畅、人力与梯队保障不足、培训支持不完善及心理支持缺乏等现实挑战。医院在推进标准化运行时，应在现有技术规范基础上，进一步优化关键流程与用物准备，完善多部门协作与信息闭环机制，强化人力梯队建设和分层培训，重视医患沟通并将心理支持纳入团队建设，以提升流程可执行性与运行可持续性。

关键词: 体外心肺复苏术, 急诊室, 医院, 团队, 标准化运行, 定性研究

Abstract:

Objective To explore the practical dilemmas in the standardized operation of extracorporeal cardiopulmonary resuscitation（ECPR） team in the emergency department of a tertiary hospital，and to provide a reference for improving standardized operational strategies. Methods A phenomenological research method was adopted. From October to December 2025，18 physicians and nurses involved in ECPR implementation in the emergency department of a tertiary hospital in Jiangsu Province were selected by purposive sampling following the principle of maximum variation sampling for semi-structured interviews. Data were analyzed using Colaizzi’s seven-step method. Results Four themes and 11 subthemes were identified：difficulty in fully implementing standardized procedures under intense time pressure and complex situations；long-term shortage of human resources and heavy workload of medical staff；a training system emphasizing technical operation over systematic competence and an imbalanced competency structure；and prominent psychological stress among medical staff in high-risk，high-cost decision-making situations. Conclusion The standardized operation of emergency department ECPR teams in tertiary hospitals faces practical challenges，including insufficient adaptation to emergency contexts，poor coordination across multiple departments，inadequate staffing and team echelon support，insufficient training support，and lack of psychological support. In promoting standardized operation，hospitals should further optimize key procedures and equipment preparation on the basis of existing technical standards，improve multidisciplinary collaboration and closed-loop information mechanisms，strengthen workforce echelon development and tiered training，emphasize communication with patients and their families，and incorporate psychological support into team building，so as to enhance procedural executability and operational sustainability.

Key words: Extracorporeal Cardiopulmonary Resuscitation, Emergency Service, Hospital, Team, Standardized Operation, Qualitative Research

顾尧, 季学丽, 周正, 黄夕华, 陈旭锋. 三级甲等医院急诊科体外心肺复苏团队标准化运行困境的质性研究[J]. 中华急危重症护理杂志, 2026, 7(8): 937-942.

GU Yao, JI Xueli, ZHOU Zheng, HUANG Xihua, CHEN Xufeng. Barriers of standardized operation of emergency department extracorporeal cardiopulmonary resuscitation team in a tertiary hospital：a qualitative study[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(8): 937-942.

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参考文献 16

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三级甲等医院急诊科体外心肺复苏团队标准化运行困境的质性研究

Barriers of standardized operation of emergency department extracorporeal cardiopulmonary resuscitation team in a tertiary hospital：a qualitative study

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