收稿日期: 2024-10-18
网络出版日期: 2025-05-07
基金资助
浙江大学医学院附属第一医院护理学科建设科研项目(2023ZYHL31)
The effect of the first-aid and emergency dual channel management scheme on the treatment efficiency of emergency patients treated by ambulance
目的 构建急救—急诊双通道管理方案,并探讨其在经救护车来院急诊患者救治中的应用效果。方法 成立研究小组,构建急救—急诊双通道管理方案,优化急诊科入口通道布局,改进经救护车就诊患者的接诊流程,在复苏单元对重症来诊患者实施分区救治、快速分流。选取2023年10月—12月浙江省某三级甲等医院急诊科经救护车来院并入抢救室治疗的患者为试验组,同期该医院另一院区患者为对照组。试验组采用双通道管理方案,对照组实施常规方案。比较两组患者的分诊时间、送检查时间、得到确定性治疗时间、“三大中心”疾病患者绿色通道停留时间的差异。结果 共纳入254例患者,其中试验组132例,对照组122例。实施双通道管理方案后,患者分诊时间从3.6(2.0,4.0) min缩短至2.1(2.0,3.0) min(P<0.001);送检查时间从58.7(29.0,73.0) min缩短至33.4(10.0,43.0) min(P<0.001);得到确定性治疗时间从76.6(31.0,98.0) min缩短至45.6(11.0,57.0) min(P<0.001);“三大中心”绿色通道停留时间从56.7(41.0,75.0) min缩短至31.0(17.0,41.0) min(P<0.05)。结论 急救—急诊双通道管理方案的应用,可减少经救护车就诊患者的分诊评估时间,缩短送检查时间、患者得到确定性治疗时间和“三大中心”疾病患者绿色通道停留时间,从而提高救治效率。
张金秋 , 沈秀兰 , 汪利萍 . 急救—急诊双通道管理方案对经救护车就诊患者救治效率的影响[J]. 中华急危重症护理杂志, 2025 , 6(5) : 585 -589 . DOI: 10.3761/j.issn.2096-7446.2025.05.015
Objective To construct a first-aid and emergency dual channel management scheme,and to explore its application effects on the treatment of emergency patients treated by ambulance. Methods A team was established to construct a first-aid and emergency dual-channel management scheme,optimize the layout of emergency department entrance channels,improve the medical treatment process for patients treated by ambulance,implement zoning treatment and rapid triage for critically ill patients in the resuscitation unit. From October to December of 2023,patients admitted to the emergency room were selected as the experimental group,and patients from another hospital campus in the same period were selected as the control group. The experimental group adopted a dual-channel management scheme,and the control group implemented a conventional protocol. The differences in triage time,examination time,definitive treatment time,and green channel stay time of patients in the "three major centers” were compared between the two groups. Results 132 patients in the experimental group and 122 patients in the control group were included. After the implementation of dual-channel management scheme,the time of patient triage was shortened from 3.6(2.0,4.0) min to 2.1(2.0,3.0) min(P<0.001),the time for examination was shortened from 58.7(29.0,73.0) min to 33.4(10.0,43.0) min(P<0.001),and the time to definitive treatment was shortened from 76.6(31.0,98.0) min to 45.6(11.0,57.0) min(P<0.001). The stay time of the green channel for patients in the “three major centers” was shortened from 56.7(41.0,75.0) min to 31.0(17.0,41.0) min (P<0.05). Conclusion The application of the first-aid and emergency dual channel management can reduce the triage time of patients transported by ambulance,shorten the examination time,treatment time and the green channel stay time for patients in the “three major centers”,thereby improving the treatment efficiency.
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