摘要
目的构建基于循证的重度急性呼吸窘迫综合征(ARDS)患者行体外膜肺氧合(ECMO)治疗院际转运的护理质控指标体系并应用。方法基于循证、结合质性研究和专家函询,构建重度ARDS患者ECMO治疗院际转运的护理质量指标体系。并选取2023年1月至12月由赣州市第五人民医院转运至赣州市人民医院行ECMO治疗的40例重度ARDS患者作为对照组,另选取2024年1月至12月由赣州市第五人民医院转运至赣州市人民医院行ECMO治疗的40例重度ARDS患者作为观察组。对照组按常规流程转运至赣州市人民医院,观察组采用循证护理质控指标体系方案转运。比较两组患者的院际转运相关指标与不良反应发生情况。结果专家积极率为100%,两轮专家权威系数分别为0.750、0.875,肯德尔系数介于0.700~0.900(P<0.05)。最终确立了3个一级指标、9个二级指标、23个三级指标。观察组的ECMO转运时间、ECMO支持时间短于对照组,差异有统计学意义(P<0.05);观察组的院际转运相关不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论本护理质控指标体系科学性和实用性较高,能减少不良事件的发生。
Objective To establish an evidence-based nursing quality control index system for patients with severe acute respiratory distress syndrome(ARDS)undergoing extracorporeal membrane oxygenation(ECMO)for interhospital transport and apply it.Methods Based on evidence-based,qualitative research and expert correspondence,a nursing quality index system for interhospital transport in ECMO treatment of severe ARDS patients was established.Forty patients with severe ARDS who were transferred from the Fifth People's Hospital of Ganzhou to Ganzhou People's Hospital for ECMO treatment from January to December 2023 were selected as the control group,and 40 patients with severe ARDS who were transferred from the Fifth People's Hospital of Ganzhou to Ganzhou People's Hospital for ECMO treatment from January to December 2024 were selected as the observation group.The control group was transferred to Ganzhou People's Hospital according to the routine process,and the observation group was transferred by the evidence-based nursing quality control index system.The inter-hospital transport related indicators and adverse reactions of the two groups were compared.Results The expert positive rate was 100%,the expert authority coefficients of the two rounds were 0.750 and 0.875,respectively,and the Kendall coefficient was between 0.700 and 0.900(P<0.05).Finally,3 first-level indicators,9 second-level indicators and 23 third-level indicators were established.The ECMO transport time and ECMO support time in observation group were shorter than those in control group,with statistically significant differences(P<0.05).The total incidence of transtransport-related adverse events in observation group was lower than that in control group,with a statistically significant difference(P<0.05).Conclusion The nursing quality control index system is scientific and practical,and can reduce the occurrence of adverse events.
作者
余先凤
刘晓兰
陈玄
YU Xianfeng;LIU Xiaolan;CHEN Xuan(Department of Critical Care Medicine,Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China)
出处
《中国当代医药》
2025年第31期180-184,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202410874)。
关键词
急性呼吸窘迫综合征
体外膜肺氧合
院际转运
护理质控
循证医学
Acute respiratory distress syndrome
Extracorporeal membrane oxygenation
Interhospital transport
Nursing quality control
Evidence-based medicine
