基于时机理论的全流程护理方案在急诊严重创伤患者中的应用

doi:10.3761/j.issn.0254-1769.2025.23.004

摘要/Abstract

摘要：

目的探讨基于时机理论的全流程护理方案在急诊严重创伤患者救治中的应用效果，为严重创伤患者的救治提供参考。方法采用便利抽样法，选取2024年6—11月在衡阳市某三级甲等综合医院就诊的90例严重创伤患者作为研究对象，其中，9—11月就诊的45例患者为试验组，在常规护理的基础上实施基于时机理论的全流程护理方案；6—8月就诊的45例患者为对照组，接受常规护理。比较两组的时效性指标、体温情况、疼痛评分、创伤后应激障碍评分和住院期间并发症发生率的差异。结果试验组和对照组最终各纳入43例。干预后，试验组建立静脉通路时间、加温措施落实时间、完善术前准备时间、急诊室滞留时间、术后交接时间及ICU入住时间均短于对照组，差异均具有统计学意义（P<0.05）；试验组体温高于对照组（P<0.05）；试验组疼痛评分、创伤后应激障碍评分及并发症发生率低于对照组，差异均具有统计学意义（P<0.05）。结论基于时机理论的全流程护理方案可提高急诊严重创伤患者救治的时效性，改善低体温和减轻疼痛，降低创伤后应激障碍程度，同时减少并发症的发生。

关键词: 时机理论, 全流程, 严重创伤, 急诊, 护理

Abstract:

Objective To explore the application effect of a whole process nursing program based on the theory of Timing It Right in the treatment of patients with severe trauma in an emergency department，and to provide a reference for the treatment of severe trauma patients. Methods Using convenience sampling，90 patients with severe trauma admitted to a tertiary A hospital in Hengyang between June and November 2024 were selected as study participants. Among them，45 patients admitted from September to November were assigned to an experimental group and received a whole process nursing program based on the theory of Timing It Right in addition to routine care. The other 45 patients admitted from June to August were assigned to a control group and received routine care only. Timeliness indicators，body temperature，pain scores，post-traumatic stress disorder scores，and the incidence of complications during hospitalization were compared between the 2 groups. Results A total of 43 patients were eventually included in each group，respectively. After the intervention，the experimental group showed significantly shorter time in establishing intravenous access，implementing warming measures，completing preoperative preparations，emergency department stay，postoperative handover，and ICU length of stay compared to the control group（P<0.05）. The experimental group also had higher body temperature，lower pain scores，lower post-traumatic stress disorder scores，and a lower incidence of complications than the control group（all P<0.05）. Conclusion The whole process nursing program based on the theory of Timing It Right can improve the timeliness of emergency care for patients with severe trauma，alleviate hypothermia and pain，reduce the severity of post-traumatic stress disorder，and decrease the incidence of complications.

Key words: Timing It Right, Whole Process, Severe Trauma, Emergency Department, Nursing Care

何沙沙, 彭艳红, 谭彩霞, 刘静, 蒋丹丹, 邹立成, 陈颖贤, 王志敏. 基于时机理论的全流程护理方案在急诊严重创伤患者中的应用[J]. 中华护理杂志, 2025, 60(23): 2843-2849.

HE Shasha, PENG Yanhong, TAN Caixia, LIU Jing, JIANG Dandan, ZOU Licheng, CHEN Yingxian, WANG Zhimin. Application of a whole process nursing program based on the theory of Timing It Right in severe trauma patients in an emergency department[J]. Chinese Journal of Nursing, 2025, 60(23): 2843-2849.

图/表 6

表1 两组一般资料的比较

Table 1 Comparison of general data between 2 groups

表2 两组时效性指标的比较（$\bar{x}±s$）

Table 2 Comparison of timeliness metrics between 2 groups（$\bar{x}±s$）

表3 两组不同救治时间点体温情况的比较（℃，$\bar{x}±s$）

Table 3 Comparison of body temperature at different treatment time points between 2 groups（℃，$\bar{x}±s$）

表4 两组不同救治时间点疼痛评分的比较（分，$\bar{x}±s$）

Table 4 Comparison of pain scores at different treatment time points between 2 groups（scores，$\bar{x}±s$）

表5 两组创伤后应激障碍评分的比较（分，$\bar{x}±s$）

Table 5 Comparison of PCL-C scores between 2 groups（scores，$\bar{x}±s$）

表6 两组住院期间并发症发生率的比较[例（百分率，%）]

Table 6 Comparison of complication incidence between 2 groups during hospitalization[cases（percentage，%）]

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