关键词: 院内急救, 急救技能, 急救模式, 院内心搏骤停, 急救护理

Abstract:

Objective To build a “3P” management model of in-hospital first aid and to evaluate the effects of its application,which provides references for improving the quality of emergency care management. Methods Through literature review,emergency management expert group discussion and 2 rounds of Delphi expert consultations,the “3P” management model index system was established and applied in the clinic from April 2017 to March 2018. Results The effective recovery rates of the 2 rounds of the questionnaire were both 100%. The authority coefficients of the experts in the second round of the questionnaire was 0.907;the judgment basis coefficient was 0.947;the familiarity coefficient was 0.867. The Kendall harmony coefficients of the importance of the first,second and third level indicators were 0.233,0.128 and 0.272,respectively. The Kendall coefficients of the operability of the first,second and third level indicators were 0.211,0.135 and 0.277;the differences were statistically significant（P<0.05）;the final "3P" management model includes 3 first-class indicators（1P：first-aid skills retraining,2P：first-aid process re-optimization,3P：first-aid materials re-allocation）,13 second-class indicators and 34 third-class indicators. After clinical application,the score of nurses’ comprehensive first-aid skills practice assessment increased from（69.07±4.80） to（85.40±2.68）;the EMSS start-up time of unexpected IHCA patients was shortened from（6.12±1.85） min to（1.26±0.60） min;the CPR start-up time was shortened from （2.72±1.35） min to （0.78±0.06） min;the defibrillation start-up time was shortened from （8.51±3.12） min to（1.43±0.94） min;the first-aid success rate of unexpected CA patients in hospital increased from 55.56% to 83.79%. The differences were statistically significant（P<0.05）. Conclusion The "3P" mode of in-hospital first aid has good reliability,scientificity and practicablity,which can provide references for improving the quality of emergency care.

Key words: In-Hospital First Aid, First Aid Skills, First Aid Model, In-Hospital Cardiac Arrest, Emergency Care