Abstract:

Objective To search，evaluate and integrate the best evidence of decision making in inter-hospital transfer of critically ill patients. Methods We searched the evidence about the decision making in inter-hospital transfer of critically ill patients in Guidelines International Network，National Guideline Clearinghouse，Canadian Medical Association CPG Infobase，Scottish Intercollegiate Guidelines Network，National Institute for Health and Care Excellence，Intensive Care Society，Registered Nurses’ Association of Ontario，and Cochrane Library，PubMed，Embase，CINAHL，Web of Science，BMJ，UpToDate、CKNI，Wanfang，and other databases. The retrieval time limit is from the establishment of the databases to June 30，2022. Literature quality assessment and data extraction were performed by 2 researchers. Results A total of 6 articles were included in this study，including 4 guidelines and 2 expert consensuses，which summarized 25 pieces of evidence involving 6 categories，namely necessity assessment，benefit and risk assessment，feasibility related factors，decision-maker，informed consent，medical records. Conclusion This study summarizes the best evidence of decision making in inter-hospital transfer of critically ill patients，and suggests that the inter-hospital transfer system should be standardized，and the outcome，existing problems should be monitored，and normative assessment tools，informed consent and medical record templates should be formed to guide the decision-making.

Key words: Emergency Nursing, Critical Illness, Inter-Hospital, Patient Transfer, Decision Making, Evidence-Based Nursing, Evidence Summary

摘要：

目的 检索、评价并整合急危重症患者院间转运决策的最佳证据。方法 检索国际指南协作网、美国国立诊疗指南库、加拿大医学会临床实践指南库、苏格兰学院间指南网、英国国家卫生与临床优化研究所等指南网，英国重症监护学会、加拿大安大略省注册护士协会等专业协会网站，以及Cochrane Library、PubMed、Embase、CINAHL、Web of Science、BMJ Best Practice、UpToDate、中国知网、万方数据库、维普数据库中有关急危重症患者院间转运决策的所有证据，检索时限为建库至2022年6月30日。由2名研究者对纳入的文献进行质量评价，并对证据进行提取、整合。结果 共纳入6篇文献，其中，指南4篇、专家共识2篇，汇总了涉及转运必要性评估、获益与风险评估、可行性相关因素、转运决策者、知情同意、病历记录6个类别的25条证据。结论 该研究总结了急危重症患者院间转运决策的最佳证据，建议规范院间转运体系建设，监测院间转运的结局，评估和解决现存问题，形成规范性的评估工具、知情同意模板及病历记录模板，用以指导转运决策。

关键词: 急诊护理, 危重症, 院间, 患者转运, 转运决策, 循证护理学, 证据总结