院前急救中的风险因素分析及管理

Analysis of Risk Factors of Pre-hospital Care and Management

目的了解院前急救中的风险因素,提出管理对策。方法自设院前急救风险问卷调查表,对浙江省内从事院前急救工作的137名医生和护士进行问卷调查。结果不同工作年限的医护人员均认为位居前3位的风险因素有2项:患者信息不准确;疾病的严重性、复杂性。另外,工作年限1～3年的医护人员较多地强调客观或他人因素带来的风险;4～6年及7年以上的医护人员有较多的共识,他们能意识到自身原因带来的风险。院前急救流程中的"重点风险环节"有:电话受理环节1项;现场救护环节6项;出车环节2项;管理环节6项。结论管理者要规范院前急救流程,加强重点风险环节管理;让院前急救人员学会识别风险,提高对风险的预见性,针对不同工作年限的医护人员分别组织学习培训,增强医护人员对重危患者病情的评估能力和预见性;主动与患者及家属沟通交流,及时履行告知义务,从而得到患者及家属的信任、理解与合作。

Objective To understand the risk factors of pre-hospital care and thus to formulate the coping management strategies.Methods By means of the questionnaire on pre-hospital care risk factors,a survey was made with 137 doctors and nurses undertaking pre-hospital care.Results The subjects of different work durations held that the top three risk factors included inaccuracy of patients’ information,the severity and complicatedness of the diseases,those with 1～3 years of work length crown objective risks and those...