摘要
目的构建基于PDCA循环的院前急救护理路径并评价其在急性心肌梗死(Acute myocardial infarction,AMI)患者中的应用效果。方法以我中心院前急救32名护理人员为研究对象,回顾性分析2023年1~12月期间进行抢救的共132例急性心肌梗死患者。选取2023年1~6月于PDCA循环实施前的60例患者为对照组;2023年7~12月实施后的72例患者为观察组。其中,对照组采用常规护理干预,观察组在常规措施基础上运用PDCA循环干预。对比分析两组院前急救时效指标(急救反应时间、首次心电图完成时间、院前抢救时间、急诊入院时间、抢救成功率、生活质量评分及满意度评分)与院前急救护理路径质量评分(文书质量评分、重点环节评分和急救专科护理评分)。结果观察组急救反应时间(5.66±1.56 vs.8.09±3.05 min)、首次心电图时间(8.12±2.23 vs.13.75±1.56 min)、抢救时间(29.72±3.65 vs.36.03±9.21 min)及急诊入院时间(23.34±8.12 vs.39.67±19.23 min)均显著低于对照组(P<0.001)。观察组抢救成功率为93.06%,显著优于对照组(88.33%)。观察组的生活质量(SF-36)及满意度评分明显高于对照组。PDCA实施后护理质量总分由(71±5.32)分提升至(87±4.15)分(P<0.01)。结论基于PDCA循环构建的院前急救护理路径能显著提升AMI救治的时效性,优化护理质量指标体系,有效改善患者心理预期及临床预后,为优化急性心肌梗死院前急救护理模式提供理论依据。
Objective To observe the application effect of PDCA cycle-based pre-hospital emergency nursing care pathway in patients with acute myocardial infarction(AMI).Methods 32 pre-hospital emergency nurses from our center were included as the study subjects.A retrospective analysis was conducted on 132 AMI patients who received resuscitation in our center between January 2023 and December 2023.Among them,60 patients treated before PDCA cycle implementation(January 2023 to June 2023)served as the control group,while 72 patients treated after implementation(July 2023 to December 2023)comprised the observation group.The control group received conventional nursing interventions,whereas the observation group received PDCA cycle interventions in addition to the conventional measures.Comparative analyses in the two groups were performed on prehospital emergency timeliness indicators(emergency response time,time to first electrocardiogram,prehospital resuscitation time,time to emergency department admission,resuscitation success rate,quality of life score,and satisfaction score),and prehospital emergency care pathway quality scores(documentation quality score,key process score,and specialized emergency nursing score).Results The emergency response time(5.66±1.56 vs.8.09±3.05 min,P<0.001),time to first electrocardiogram(8.12±2.23 vs.13.75±1.56 min,P<0.001),resuscitation time(29.72±3.65 vs.36.03±9.21 min,P<0.001),and time to emergency department admission(23.34±8.12 vs.39.67±19.23 min,P<0.001)of the observation group were all significantly lower than those of the control group.The resuscitation success rate was significantly higher in the observation group(93.06%vs.88.33%).The observation group demonstrated significantly higher scores in both quality of life(assessed by SF-36)and satisfaction compared to the control group.Following PDCA implementation,the total nursing quality score increased from 71±5.32 to 87±4.15(P<0.01).Conclusion The PDCA cycle-based pr-ehospital emergency nursing care pathway significantly enhances the timeliness of AMI pre-hospital emergency care,optimizes the nursing quality indicator system,and effectively improves patient expectations and clinical prognosis,and provide a theoretical basis for optimizing the prehospital emergency care model for AMI.
作者
刘艳俊
孙翔玉
Liu Yanjun;Sun Xiangyu(Beijing Chaoyang District Emergency Medical Rescue Center,Beijing 100026,China;Department of Pharmaceutical and Equipment,Beijing Chaoyang District Emergency Medical Rescue Center,Beijing 100026,China)
出处
《青岛医药卫生》
2025年第6期420-424,共5页
Qingdao Medical Journal
关键词
院前急救护理路径
急性心肌梗死
PDCA
prehospital emergency nursing care pathway
acute myocardial infarction
PDCA cycle
