朱静洋 张振宇

[摘要] 目的 觀察标准化分级转运方案对急诊妇产科危急重症患者院内转运的影响，旨在为标准化分级转运方案的顺利开展提供参考。 方法 采用整群抽样法，回顾性分析2017年1—12月首都医科大学附属北京妇产医院（以下简称“我院”）开展标准化实施前200例妇产科危重症患者的临床资料，作为对照组。同时，回顾性分析2018年1—12月我院开展标准化分级转运方案后220例妇产科危重症患者的临床资料，作为观察组。比较两组患者在转运途中不良事件的发生率、转运完成时间及护理满意度情况。 结果 观察组转运途中坠床、阴道出血、病情恶化及胎动异常发生率显著低于对照组，差异有统计学意义（P < 0.05）。观察组完成各项转运时间显著短于对照组，差异有统计学意义（P < 0.05）。观察组护理满意度显著高于对照组，差异有统计学意义（P < 0.05）。 结论 标准化分级转运方案的开展与实施，能够降低急诊科危重症患者院内转运的不良事件发生率，显著缩短转运时间，提高满意度。建议在我院危重症患者院内转运中开展、实施，以提高转运安全性。

[关键词] 急诊妇产科;危急重症;标准化分级转运;院内转运

[中图分类号] R472.2          [文献标识码] A          [文章编号] 1673-7210（2020）07（c）-0185-04

Influence of standardized grading transfer program in department of emergency obstetrics and gynecology of critically ill patients on nosocomial transfer

ZHU Jingyang   ZHANG Zhenyu

Emergency Room， Beijing Obstetrics and Gynecology Hospital， Capital Medical University， Beijing   100026， China

[Abstract] Objective To observe the impact of standardized grading transfer program on nosocomial transfer of critically ill patients in department of emergency obstetrics and gynecology， and to provide a reference for the smooth implementation of standardized grading transfer program. Methods A cluster sampling method was used to retrospectively analyze the clinical data of 200 patients with critical gynecology and obstetrics in Beijing Obstetrics and Gynecology Hospital， Capital Medical University （hereinafter referred to as “our hospital”） from January to December 2017， as the control group. Retrospectively analyze the clinical data of 220 gynecological and critically ill patients after the standardized grading transfer program were carried out in our hospital from January to December 2018， as the observation group. The incidence of adverse events during the transfer， the time of completion of the transfer， and nursing satisfaction were compared between the two groups. Results The incidence of falling bed， vaginal bleeding， worsening of the condition and abnormal fetal movement during the transportation of the observation group were significantly lower than those of the control group， and the differences were statistically significant （P < 0.05）. The various time for completing the transfer in the observation group were significantly shorter than those in the control group， and the differences were statistically significant （P < 0.05）. The nursing satisfaction of the observation group was significantly higher than that of the control group， and the difference was statistically significant （P < 0.05）. Conclusion The development and implementation of the standardized grading transfer program can reduce the incidence of adverse events in nosocomial transport of critically ill patients in the department of emergency， significantly shorten the time of transport， and improve satisfaction. It is recommended to carry out and implement nosocomial transport of critically ill patients in our hospital to improve transport safety.

[Key words] Department of emergency obstetrics and gynecology; Critically ill; Standardized grading transfer; Nosocomial transfer

急诊科是危急重症患者入院首次接触的场所，危重症患者病情严重、多变且进展快、生命支持高度依赖等特点常需依靠院内转运，明确诊断，在最短时间内接受专科治疗，以达到理想预后[1-3]。危重症患者常需在同一医疗单位不同医疗区域进行转运，且院内转运时患者常处于移动状态，诸多因素均可导致病情突变[4-5]。因此，探寻合理高效的转运方案，对保障转运过程的安全、降低不良事件的发生率具有重要意义。标准化分级转运是指在对患者生命特征、呼吸支持、意识状态、主要临床问题及转运时间做出充分评估后，设计转运方案、所需医疗设备、人员支持、各科室协调等方面均到位，旨在确保转运过程安全、顺利及应对突发事件的解决能力，并于结束后，对整个过程进行总结、评价、改进[6-7]。……