基于德尔菲法构建急性心肌梗死急诊护理路径及效果评价

Emergency nursing pathway for acute myocardial infarction based on Delphi method and effect evaluation

目的基于德尔菲法构建急性心肌梗死(AMI)急诊护理路径,并探讨患者急诊护理效果。方法根据文献研究法和人员访谈法,结合本院急诊实际情况设计AMI急诊护理路径,并通过德尔菲法专家咨询确定护理路径各级指标,采用历史对照的方式以分诊评估时间、球囊扩张时间、住院后复发率、经皮冠状动脉介入术(PCI)再行率为指标进行效果评价。结果本研究建立了3项一级指标,12项二级指标和45项三级指标的具体AMI急诊临床护理路径,且专家积极程度(93.33%、100%)、权威程度(0.875、0.880)及协调程度良好(P<0.05),观察组的AMI急诊护理效果在分诊评估时间、球囊扩张时间、AMI复发率及PCI再行率优于对照组(P<0.05)。结论创建AMI急诊护理路径可有效规范急诊对心肌梗死患者的急诊流程,提升AMI患者的急诊护理质量和抢救成功率。

Objective To set up the emergency nursing pathway for acute myocardial infarction based on Delphi method,and to explore the effects of emergency nursing for patients.Methods The emergency nursing path for acute myocardial infarction was set up in combination with actual conditions of emergency treatments of the hospital based on the literature research method and personnel interview method,the indexes of the nursing pathway through the Delphi method expert consultation were determined,and finally historical control method was used to evaluate the effects in terms of the triage evaluation duration,balloon dilatation duration,the recurrence rate after hospitalization,and PCI recurrence rate.Results Specific AMI emergency clinical nursing pathways for 3 primary nursing indexes,12 secondary indexes and 45 tertiary indexes,and the experts’degree of enthusiasm(93.33%,100%)and authority(0.875,0.880)and degree of coordination were satisfactory(P<0.05).The effect of AMI emergency nursing on patient in the observation group was significantly better than that of patients in the control group for the triage evaluation duration,balloon dilatation duration,recurrence rate of AMI and retransmission rate of PCI(P<0.05).Conclusion The emergency nursing pathway for acute myocardial infarction set up can effectively regulate the emergency procedure of patients with myocardial infarction and improve the quality of emergency nursing and the success rate of rescue in patients with AMI.