急性主动脉夹层患者急诊临床恶化动态预警方案的构建及应用研究

doi:10.3761/j.issn.2096-7446.2022.06.001

Abstract

Abstract: Objective To construct a dynamic warning plan for emergency clinical deterioration of patients with acute aortic dissection and evaluate the application effect. Methods Based on the literature and the previous research results,the research group improved the National Early Warning Score to construct the first draft of the plan for dynamic waning of emergency clinical deterioration in patients with acute aortic dissection. Through the expert meeting,the final draft was formed. 26 patients with acute aortic dissection in the emergency department from a tertiary class A cardiovascular hospital in Beijing were selected by convenient sampling. The patients were divided into the control group（14 cases） and the intervention group（12 cases） by random number table method. The control group was given routine care,and the intervention group received the dynamic waning plan of emergency clinical deterioration. Results A total of 14 clinical and nursing experts participated in the expert meeting,and the authority coefficient of the experts was 0.89. Dynamic warning scheme of the emergency clinical deterioration in patients with acute aortic dissection consisted of evaluation index and the clinical response of nursing measures, evaluation index included systolic blood pressure, heart rate,breathing, SpO₂, consciousness level and the degree of pain, clinical response nursing measures were responded according to three levels from low to high graded by the score of evaluation index. After the application of this plan,the frequency of consciousness and pain assessment of nurses in the experimental group was higher than that in the control group（P<0.001）,and the frequency of informing doctors in the experimental group was higher and the mortality rate was lower,but the differences were not statistically significant（P>0.05）. Conclusion The dynamic warning plan constructed in this research provided suggestions for clinical nursing strategies according to the change of different assessment indicators,which can further improve emergency nursing for acute aortic dissection patients.

Key words: Acute Aortic Dissection, Emergency Department, Clinical Deterioration, Early Warning Score, Nursing Evaluation Research

LIU Yuwen, LI Qingyin, LIU Tian, ZHANG Yanjuan, ZHAO Rui, PANG Ran, REN Hua. The construction and application of dynamic warning plan for emergency clinical deterioration of patients with acute aortic dissection[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(6): 485-490.

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The construction and application of dynamic warning plan for emergency clinical deterioration of patients with acute aortic dissection

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