摘要
目的研究基于4R危机理论的一体化护理在急诊多发性创伤患者急救护理中的应用效果。方法选取2023年2月至2024年1月郑州大学第一附属医院收治的100例多发性创伤患者作为研究对象,按随机数表法分为研究组和对照组各50例,对照组患者采用常规护理干预,研究组患者采用基于4R危机理论的一体化护理干预,两组患者均护理至出院。出院前,比较两组患者的救护效果、诊疗时间(院前急救时间、多科会诊时间、急诊抢救时间、转运时间、检查等待时间)和护理前后(出院前)的损伤严重度评分(ISS)、创伤患者评分量表(CRAMS)评分;同时比较两组患者治疗期间的不良事件发生率。结果研究组患者的救护效率为94.00%,明显高于对照组的76.00%,差异有统计学意义(P<0.05)。研究组患者院前急救时间、多科会诊时间、急诊抢救时间、转运时间、检查等待时间分别为(15.07±2.59)min、(5.01±1.13)min、(80.38±12.97)min、(9.27±2.10)min、(0.83±0.15)min,明显短于对照组的(20.01±3.78)min、(10.83±2.06)min、(102.64±18.28)min、(12.90±2.21)min、(2.70±0.79)min,差异均有统计学意义(P<0.05)。护理前,两组患者的ISS、CRAMS评分比较差异均无统计学意义(P>0.05);护理后,两组患者的ISS评分均较护理前下降,CRAMS评分较护理前上升,且研究组患者的ISS评分为(30.27±3.08)分,明显低于对照组的(37.10±4.21)分,CRAMS评分为(6.97±1.29)分,明显高于对照组的(5.38±1.35)分,差异均有统计学意义(P<0.05)。治疗期间研究组患者的不良事件发生率为4.00%,明显低于对照组的16.00%,差异有统计学意义(P<0.05)。结论基于4R危机理论的一体化护理在急诊多发性创伤患者急救护理中的应用效果显著,能够有效发挥各护理人员的职责,减少不必要的流程,提高抢救效率,减少不良事件发生,促进预后恢复。
Objective To investigate the application effect of integrated nursing based on 4R crisis theory in emergency care for patients with multiple trauma.Methods A total of 100 patients with multiple trauma admitted to the First Affiliated Hospital of Zhengzhou University from February 2023 to January 2024 were selected as the study subjects.They were randomly divided into a research group and a control group,with 50 patients in each group.The control group received routine nursing interventions,while the research group received integrated nursing based on 4R crisis theory.Both groups were cared for until discharge.Before discharge,the rescue efficiency,diagnosis and treatment times(pre-hospital emergency time,multi-disciplinary consultation time,emergency rescue time,transfer time,and examination waiting time),Injury Severity Score(ISS),and CRAMS(Circulation,Respiration,Abdomen,Motor,and Speech)scores before and after nursing(before discharge)were compared between the two groups.Additionally,the incidence of adverse events during treatment was compared between the two groups.Results The rescue efficiency in the research group was 94.00%,significantly higher than 76.00%in the control group(P<0.05).The pre-hospital emergency time,multi-disciplinary consultation time,emergency rescue time,transfer time,and examination waiting time in the research group were(15.07±2.59)min,(5.01±1.13)min,(80.38±12.97)min,(9.27±2.10)min,and(0.83±0.15)min,respectively,significantly shorter than(20.01±3.78)min,(10.83±2.06)min,(102.64±18.28)min,(12.90±2.21)min,and(2.70±0.79)min in the control group(P<0.05).Before nursing,there were no significant differences in ISS and CRAMS scores between the two groups(P>0.05).After nursing,the ISS scores decreased,and the CRAMS scores increased in both groups.The ISS score in the research group was(30.27±3.08)points,significantly lower than(37.10±4.21)points in the control group,and the CRAMS score was(6.97±1.29)points,significantly higher than(5.38±1.35)points in the control group(P<0.05).The incidence of adverse events during treatment in the research group was 4.00%,significantly lower than 16.00%in the control group(P<0.05).Conclusion The application of integrated nursing based on 4R crisis theory in emergency care for patients with multiple trauma has significant effects.It can effectively clarify the responsibilities of nursing staff,reduce unnecessary procedures,improve rescue efficiency,decrease the incidence of adverse events,and promote recovery.
作者
宋雨轩
杜亚泽
SONG Yu-xuan;DU Ya-ze(Department of Emergency,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,CHINA)
出处
《海南医学》
2025年第14期2115-2118,共4页
Hainan Medical Journal
基金
河南省医学科技攻关计划项目(编号:LHGJ20191179)。
关键词
多发性创伤
急诊
4R危机理论
一体化护理
预后
Multiple trauma
Emergency
4R crisis theory
Integrated nursing
Prognosis
