急诊过度拥挤对急性脑卒中患者护理质量的影响

Advanced Journal of Emergency Medicine Pub Date : 2017-12-04 eCollection Date: 2018-01-01 DOI:10.22114/AJEM.v0i0.25
Mehdi Momeni, Elnaz Vahidi, Javad Seyedhosseini, Alemeh Jarchi, Zeinab Naderpour, Morteza Saeedi
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引用次数: 12

摘要

导言:急诊过度拥挤的定义是病人所需的护理量超过了现有的护理量。这可能导致在中风等情况下提供重症护理的延误。目的:本研究旨在评估急诊科(ED)拥挤对急性脑卒中患者护理质量的可能影响。方法:在这项横断面前瞻性研究中,纳入所有在教育医院急诊科就诊的有急性脑卒中症状的患者。所有患者均由值班的急诊医学(EM)住院医师进行评估和检查,并为他们填写问卷。分诊护士记录了从第一次分诊到执行所需干预措施和提供保健服务的时间。通过入住率来衡量急诊科的拥挤程度。然后,计算各变量与ED拥挤程度的相关关系。结果:平均每日床位入住率为184.9±54.3%。从第一次分诊到实施干预的中位数时间如下:第一次急诊住院时间为34 min,第一次神经内科就诊时间为138 min,第一次头部CT检查时间为134 min,第一次心电图检查时间为104 min,第一次ASA给药时间为210 min。卒中患者ED占用率与全天或每8小时间隔所需的不同卫生服务时间之间无统计学意义(p > 0.05)。结论:在本研究中,急诊科使用率与入院急性脑卒中患者管理相关的时间框架无显著相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Emergency Overcrowding Impact on the Quality of Care of Patients Presenting with Acute Stroke.

Introduction: Emergency overcrowding is defined as when the amount of care required for patients overcomes the available amount. This can cause delays in delivering critical care in situations like stroke.

Objective: The aim of this study was to assess the possible impact of emergency department (ED) crowding on the quality of care for acute stroke patients.

Methods: In this cross-sectional prospective study, all patients with symptoms of acute stroke presenting to the ED of educational hospitals were enrolled. All patients were assessed and examined by the emergency medicine (EM) residents on shift and a questionnaire was filled out for them. The amount of time that passed from the first triage to performing the required interventions and delivering health services were recorded by the triage nurse. ED crowding was measured by the occupancy rate. Then, the correlation between all of the variables and ED crowding level were calculated.

Results: The average daily bed occupancy rate was 184.9 ± 54.3%. The median time passed from the first triage to performing the interventions were as follows: the first EM resident visit after 34 min, the first neurologic visit after 138 min, head CT after 134 min, ECG after 104 min and ASA administration after 210 min. There was no statistically significant relationship between the ED occupancy rate and the time elapsed before different required health services in the management of stroke patients either throughout an entire day or during each 8-hour interval (p > 0.05).

Conclusion: In the current study, the ED occupancy rate was not significantly correlated with the time frame associated with management of admitted acute stroke patients.

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