临床路径在ST段抬高性心肌梗死应用中变异因素的分析

Variation analysis in clinical pathway for ST elevation myocardial infarction

目的:探讨临床路径在ST段抬高性心肌梗死(ST elevation myocardial infarction,STEMI)应用中变异因素,以便进一步提高临床路径实施的质量。方法:对我院2010年3月至2011年9月收治的203例急性STEMI患者的临床路径资料进行分析,并对其变异因素进行相关分析。结果:203例中共有122例未完成临床路径(60.10%),其病人或家属因素114例(93.44%),医务人员因素6例(4.92%),设备因素2例(1.64%);而其中包含医疗费用问题45例(36.89%),并发症42例(34.43%)。结论:通过对急性STEMI临床路径变异情况分析,查明变异原因,及时有效地采取干预措施,补充和完善临床路径内容,提高治疗和护理质量,减少变异,保证临床路径顺利实施。

Objective：To explore the variation factors in the implementation of clinical pathway in ST elevation myocardial infarction,so as to further improve the quality of clinical pathway implementation.Methods：In our hospital from March 2010 to September 2011,clinical path data of 203 cases of acute ST elevation myocardial infarction patients for were analyzed,and correction analysis was conducted to the variation analysis interrelated factors.Results：A total of 122 patients with 203 cases did not complete a clinical pathway（60.10%）,the patient or family member factors in 114 cases（93.44%）,medical personnel factor in 6 cases（4.92%）,equipment factors in 2 cases（1.64%）,which includes medical cost problems in 45 cases（36.89%）,and complications in 42 cases（34.43%）.Conclusion：Clinical pathway variations analysis for STEMI helps to find out the reasons for variation and to reduce variation.Clinical pathway can be smoothly fulfilled through timely and effective intervention,and by supplementing and completing the clinical pathway content,so as to improve the treatment and caring quality.