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目的:探究危重患者早期识别模式在心脏外科安全管理中的实施价值。方法:自2015年1月起在浙江省东阳市人民医院心脏外科实施危重患者早期识别模式管理,该方案中以改良早期预警评分作为评价基础,应用标准化沟通模式,通过核查表来评估患者的具体情况,根据改良早期预警评分分值不同,给予不同内容、级别的护理干预,分别调查危重患者早期识别模式管理方案实施前后护士和医生的满意度情况,并以2014年为对照,统计实施前后患者非预期监护室入住率。结果:在实施危重患者早期识别模式管理方案后,护士在工作效率、信心程度、信息掌握、交接班、风险回避等项目的满意度上显著高于实施前(P<0.05);实施危重患者早期识别模式管理方案后,医生在工作效率、信心程度、信息掌握、治疗方案选择、护士工作成效的满意度上显著高于实施前(P<0.05);实施危重患者早期识别模式管理方案后,心脏外科患者非预期监护室入住率从2014年的6.3%,降为了2015年的1.5%(P<0.05)。结论:危重患者早期识别模式应用于心脏外科安全管理,能够有效提高医护人员的满意度,增强其工作信心及工作效率,同时也提高了患者的安全管理效果。
Objective: To explore the value of early identification of critically ill patients in the safety management of cardiac surgery. METHODS: Since January 2015, the Department of Cardiology, Dongyang People’s Hospital of Zhejiang Province implemented the management of early identification of critically ill patients. In this program, the improved early warning score was used as the basis for evaluation. Standardized communication mode was used to check the patient’s specific According to the scores of improved early warning score, different levels and contents of nursing intervention were given to investigate the satisfaction of nurses and doctors before and after the implementation of early identification mode management program of critically ill patients respectively. The data of 2014 were compared with those before and after the implementation of statistics Unintended guard room occupancy rate. Results: After implementing the program of early identification of critically ill patients, nurses were significantly higher in satisfaction with job efficiency, confidence, information control, handovers and risk avoidance than those before implementation (P <0.05) After recognizing the pattern management program, the doctors were significantly more satisfied with the work efficiency, confidence, information control, treatment options, and job satisfaction of the nurses than before the implementation (P <0.05). After implementing the program of early identification of critically ill patients, the heart Surgical patients unintended care room occupancy rate dropped from 6.3% in 2014 to 1.5% in 2015 (P <0.05). Conclusion: Early identification of critically ill patients in cardiac surgery safety management can effectively improve the satisfaction of medical staff, enhance their working confidence and work efficiency, and improve the safety management of patients.