中华急危重症护理杂志2024，Vol.5Issue(4) ：305-311.DOI:10.3761/j.issn.2096-7446.2024.04.003

转运标准化流程管理在儿科体外膜肺氧合快速反应团队中的应用

Application of standardized transport process management in pediatric extracorporeal membrane oxygenation rapid response team

黄雅丽 蔡淑红 王谢磊 郑义熔
中华急危重症护理杂志2024，Vol.5Issue(4) ：305-311.DOI:10.3761/j.issn.2096-7446.2024.04.003
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转运标准化流程管理在儿科体外膜肺氧合快速反应团队中的应用

Application of standardized transport process management in pediatric extracorporeal membrane oxygenation rapid response team

黄雅丽 1蔡淑红 1王谢磊 1郑义熔1
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作者信息

  • 1. 350001 福州市 福建省儿童医院/上海儿童医学中心福建医院/福建医科大学妇儿临床医学院心脏外科重症监护室
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摘要

目的 构建儿科体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)快速反应团队转运标准化流程管理方案并分析其应用效果.方法 通过文献检索、专家函询构建ECMO快速反应团队转运标准化流程管理方案.连续收集2021年7月—2022年12月福建省某儿童医院收治的19例行ECMO治疗的新生儿资料,其中2022年1月—12月基于ECMO快速反应团队开展ECMO治疗的11例患儿为试验组,采用ECMO快速反应团队转运标准化流程;2021年7月—12月开展常规ECMO治疗的8例患儿作为对照组,采用常规ECMO救治流程.比较两组团队准备时间、置管时间、急救技术、专业知识、抢救秩序、配合抢救速度、应急主动性、急救综合满意度,以及两组患儿神经系统并发症和住院期间死亡例数的差异.结果 试验组的团队准备时间(33.10±6.06)min、置管时间(47.45±6.73)min均较对照组明显缩短,团队成员的急救综合满意度较干预前明显提高,差异均具有统计学意义(P＜0.001);两组各出现2例神经系统并发症,试验组2例患儿在住院期间死亡.结论 儿科ECMO快速反应团队转运标准化流程管理可以缩短ECMO救治启动时间,提高团队成员急救综合满意度,对急危重症患儿的救治具有积极作用.

Abstract

Objective A standardized transport process management for pediatric extracorporeal membrane oxy-genation(ECMO)-rapid response team(RRT)was constructed and applied,and its application effect was analyzed.Methods ECMO-RRT standardized transport process management was constructed through literature search,expert consultation.We continuously selected 19 patients who applied ECMO treatment in a children hospital in Fujian Province from July 2021 to December 2022 as the study subjects,including 11 cases admitted in January to De-cember 2022 as the experimental group,and 8 cases admitted from July 2021 to December 2021 as the control group.The experimental group was implemented by a ECMO-RRT standardized transport process management,and the control group was implemented by a routine ECMO treatment process.The differences in team preparation time,time of catherterization,first aid technique,professional knowledge,rescue order,cooperative rescue speed and emer-gency initiative,rescue comprehensive satisfaction,the occurrence of neurological complications and the number of deaths during hospitali were compared between two groups.Results Compared with the control group,the team preparation time(33.10±6.06)minutes,the time of catherterization(47.45±6.73)minutes were significantly shortened,and comprehensive satisfaction in the experimental group increased significantly.The differences were statistically significant(P＜0.001).There were 2 cases of neurological complications in each of the two groups,and 2 cases in the experimental group died during hospitalization.Conclusion The application of the ECMO-RRT standardized transport process management for pediatric ECMO patients can shorten the time of initiation of ECMO treatment and improve the overall satisfaction of team members and has a positive effect on the treatment of critically ill pe-diatric patients.

关键词

护理标准/流程管理/医院快速反应小组/体外膜氧合作用/危重病护理

Key words

Standard of Care/Process Management/Hospital Rapid Response Team/Extracorporeal Membrane Oxygenation/Critical Care Nursing

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出版年

2024
中华急危重症护理杂志

中华急危重症护理杂志

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