基于“需求导向”的九寨沟地震二线前哨医院护理应急救治模式构建

Construction of the mode of emergency nursing treatment based on ＂demand orientation＂ in the second-line hospitals during Jiuzhaigou Earthquake

2017年8月8日21：19，四川省阿坝州九寨沟县遭受里氏7．0级地震，致24人死亡，493人受伤（重伤45人）。作为距离灾区最近的绵阳市中心医院，有数次参与汶川、玉树、芦山地震的救援经验，成为该次地震救援主要的二线前哨医院。医院先后4批次派出灾害救援医生和护士组成医疗队前往灾区检伤、分类和后送。根据马斯洛的层次需求理论建立了“以需求为导向”的“3＋5”护理应急模式；动员病情较轻的住院患者回家休息，腾空骨科病房收治九寨沟地震伤员；9名具备国家二级心理咨询师资格证的护士对伤员进行了早期心理评估和干预；由骨科、神经外科、身心疾病科、康复科组建多学科合作护理团队，利用晨间SBAR交班模式及查房机会共同探讨患者的专科护理、并发症预防及术后快速康复。该模式收到良好效果，救治期间未发生死亡、感染及并发症。

At 21：19 a 7.0 Richter degree earthquake struck Jiuzhaigou, Tibetan-Qiang Autonomous Prefecture of Ngawa, Sichuan Province, and led 24 people to death. 493 people were wounded, 45 being severely injured . Having participating in the medical rescue in Wenehuan, Yushu, and Lushan Earthquakes, the Mianyang Central Hospital, situated in Mianyang, the nearest city from the disaster area, played the role of the main second-line outpost hospital. Four batches of medical rescue teams, with disaster physicians and nurses, were dispatched thereby. A ＂3 ＋ 5＂ Emergency Treatment Mode, targeting the demand of the wounded based on Maslow＇s theory of hierarchy of needs and the time staging of injury, were developed. The in-patients with mild condition, were mobilized to go home so as to vacate the wards and establish temporary wards to receive the severe patients from Jiuzhaigou. Nine nurses with the national secondary psychological consultant certificates were organized to conduct psychological assessment and Psychological intervention for those patients in bereavement and the pediatric patients. A multidisciplinary team （MDT） was established with nurses from the departments of orthopedics, neurosurgery, psychosomatic disease, and rehabilitation to implement＇ the use of the SBAR communication tool during shifting of duty. Individualized nursing programs were developed for every patient. This mode produced good effects. No death, infection, and complication was seen among the wounded evacuated and treated.