护士主导的移动体外膜肺氧合患者区域转运标准化流程的构建及应用

doi:10.3761/j.issn.0254-1769.2023.17.001

摘要/Abstract

摘要：

目的构建护士主导的移动体外膜肺氧合患者区域转运标准化流程，并分析其应用效果。方法在体外生命支持组织体外膜肺氧合转运指南意见基础上，通过文献检索、专家咨询及演练测试，构建护士主导的移动体外膜肺氧合患者区域转运标准化流程。采取便利抽样法，连续选取2020年8月—2022年7月于浙江省某三级甲等医院综合ICU应用移动体外膜肺氧合院外救治的82例患者作为研究对象，其中，2021年8月—2022年7月收治的47例作为试验组，2020年8月—2021年7月收治的35例作为对照组。试验组实施护士主导的移动体外膜肺氧合患者区域转运标准化流程，对照组实施常规体外膜肺氧合患者转运流程，比较两组物资准备时间、人员到齐出发时间、铺巾到体外膜肺氧合血液流转时间及转运不良事件发生率的差异。结果两组在性别、年龄、疾病种类方面的比较，差异无统计学意义；与对照组相比，试验组物资准备时间（10.09±2.96） min、人员到齐出发时间（12.74±4.61） min及铺巾到体外膜肺氧合血液流转时间（31.40±6.44） min明显缩短，试验组转运不良事件发生率明显下降，差异具有统计学意义（P<0.05）。结论护士主导的移动体外膜肺氧合患者区域转运标准化流程的应用可缩短转运相关时间，降低转运过程中不良事件的发生率，护士主导对提高体外膜肺氧合患者转运效率和降低转运风险具有积极作用。

关键词: 护士主导, 移动体外膜肺氧合, 区域转运, 标准化流程, 护理

Abstract:

Objective A nurse-led standardized process for regional transport of mobile extracorporeal membrane oxygenation（ECMO） patients was constructed and applied，and its application effect was analyzed. Methods Based on the opinions of extracorporeal life support organization ECMO transport guidelines，a nurse-led standardized process for the regional transport of mobile ECMO patients was constructed through literature search，expert consultation and exercise testing. A convenient sampling method was used to continuously select 82 patients who applied mobile ECMO out-of-hospital treatment in the general care unit of a tertiary hospital in Zhejiang Province from August 2020 to July 2022 as the study subjects，including 47 cases admitted in August 2021 to July 2022 as the experimental group，and 35 cases admitted from August 2020 to July 2021 as the control group. The experimental group was implemented by a nurse-led standardized transport process for mobile ECMO patients，and the control group was implemented by a routine mobile ECMO patient transport process，and the differences in material preparation time，departure time of personnel，time from towel laying to transferring，and transport adverse event rate were compared between the 2 groups. Results There were no significant differences in gender，age，and disease type between the 2 groups. Compared with the control group，the material preparation time（10.09±2.96）minutes, the departure time of personnel arrival （12.74±4.61） minutes and the time from towel laying to transferring（31.40±6.44） minutes were significantly shortened, and the incidence of adverse events in the experimental group decreased significantly. The differences were statistically significant（P<0.05）. Conclusion The application of the nurse-led standardized process for regional transport of mobile ECMO patients can shorten the time related to transport and reduce the incidence of adverse events during transport，and the nurse-led transport can improve its efficiency and reduce the transport risk of ECMO patients.

Key words: Nurse-Led, Mobile Extracorporeal Membrane Oxygenation, Regional Transport, Standardized Process, Nursing Care

李莲, 王金宁, 陈臣侃, 金佳家, 潘向滢. 护士主导的移动体外膜肺氧合患者区域转运标准化流程的构建及应用[J]. 中华护理杂志, 2023, 58(17): 2053-2058.

LI Lian, WANG Jinning, CHEN Chenkan, JIN Jiajia, PAN Xiangying. Construction and application of standardized process for regional transport of mobile extracorporeal membrane oxygenation patients led by nurses[J]. Chinese Journal of Nursing, 2023, 58(17): 2053-2058.

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