两医三护医护配合模式在急诊科危重患者抢救中的应用

Application of two-doctor three-nurse cooperation pattern on severe and critical patients in emergency medicine department

目的探讨急诊危重患者抢救中的医护配合模式。方法以采用两医三护医护配合模式进行抢救的120例心跳呼吸骤停患者为观察组,采用传统急救方法抢救的120例心跳呼吸骤停患者为对照组,通过查阅病历资料,收集抢救各项资料、指标。比较两组的抢救成功率、医师及患者家属对抢救的满意度。结果观察组抢救成功率96%（115/120）,高于对照组83%（99/120）,两组比较差异有统计学意义（χ~2=11.04,P〈0.01）。观察组医师对护士观察病情及时性（t=23.75,P〈0.01）、执行医嘱准确性（t=15.86,P〈0.01）、执行医嘱及时性（t=14.58,P〈0.01）、实施急救措施条理性（t=32.75,P〈0.01）、急救操作规范性（t=12.85,P〈0.01）、急救物品备齐率（t=14.31,P〈0.01）、急救仪器完好率（t=44.95,P〈0.01）、急救仪器使用熟练性（t=43.51,P〈0.01）、医护配合协调性（t=19.57,P〈0.01）及终末处理效果（t=18.48,P〈0.01）满意度均优于对照组,差异均有统计学意义。观察组患者及家属对护士观察病情及时性（t=9.36,P〈0.01）、医师观察及时性（t=9.69,P〈0.01）、医师处理及时性（t=23.57,P〈0.01）、护士处理及时性（t=3.09,P〈0.01）、急救效果（t=7.13,P〈0.01）、医师服务态度（t=13.63,P〈0.01）、护士服务态度（t=6.00,P〈0.01）满意度均优于对照组,差异均有统计学意义。结论两医三护医护配合模式在危重患者救护中具有科学性、实用性,对提高患者抢救成功率具有积极意义,值得推广。

Objective To explore cooperation pattern of doctor and nurse in first aid of severe and critical patients.Methods120 patients with cardiopulmonary arrest who were applied two-doctor three-nurse cooperation pattern were chosen as observation group,while 120 patients with cardiopulmonary arrest who were treated by traditional first aid method were chosen as control group.Data and rescue indexes were collected through checking the medical records.And rate of successful rescue,rescue satisfaction rates from patients＇ families and physicians were compared between the two groups.Results Rate of successful rescue of observation group was 96%（115/120）,which was higher than that of the control group 83%（99/120）,and the difference between the two groups was statistically significant（χ~2=11.04,P〈0.01）.Physicians＇ satisfaction rates on nurses＇ timeliness of observation time（t=23.75,P〈0.01）,accuracy of executing orders（t=15.86,P〈0.01）,timeliness of executing orders（t=14.58,P〈0.01）,orderliness of taking measures for first aid（t=32.75,P〈0.01）,normalization of emergency operation standard（t=12.85,P〈0.01）,sufficiency rate of emergency readiness（t=14.31,P〈0.01）,complete rate of first aid instrument（t=44.95,P〈0.01）,proficiency of using first aid instruments（t=43.51,P〈0.01）,coordination of doctor-nurse cooperation（t=19.57,P〈0.01） and end treatment effect（t=18.48,P〈0.01） of observation group were better than those of control group,and the differences were statistically significant（P〈0.05）.Satisfaction rates of patients and their families on timeliness of nurses＇ observation time（t=9.36,P〈0.01）,timeliness of physicians＇ observation time（t=9.69,P〈0.01）,timeliness of physicians＇ disposing disease（t=23.57,P〈0.01）,timeliness of nurses＇ disposing disease（t=3.09,P〈0.01）,first aid effect（t=7.13,P〈0.01）,physicians＇ service attitude（t=13.63,P〈0.01）,nurses＇ service attitude（t=6.00,P〈0.01） of observation group were better than those of control group,and the differences were statistically significant（P〈0.05）.Conclusions Two-doctor three-nurse cooperation pattern is scientific and practical in rescue of severe and critical patients,has a positive significance to improve patients＇ first aid success rate,and worthy of promoting.