胸痛患者行急诊PCI通道时间点的管理

Management of Emergeny PCI Access for Patients with Chest Pain

目的探讨急诊护士流程改变在缩短胸痛患者行PCI绿色通道的时间点管理中的应用价值。方法共纳入2015年1月—6月(对照组)与2016年1月—12月(观察组)诊断AMI患者112例,对照组(56例)护士采用旧急诊分诊接诊流程,观察组(56例)采用优化后急诊分诊接诊流程,比较两组就诊时间、发病时间、心电图时间、肌钙蛋白抽血和报告时间、通知心内科住院总时间、双联抗血小板药物时间、开始谈话时间、签署知情同意书时间、通知导管团队和到位时间、通知转运和到达导管室时间,分析D-to-B平均时间和合格率。结果观察组的通知心内科住院总时间、双联抗血小板药物时间、开始谈话时间、签署知情同意书时间、通知导管团队和到位时间、通知转运和到达导管室时间均明显短于对照组,差异有统计学意义(P<0.05)。观察组的D-to-B平均时间显著短于对照组,合格率高于对照组,差异有统计学意义(P<0.05)。结论急诊分诊可显著缩短胸痛患者行PCI绿色通道的多个时间点,提高D-to-B合格率。

Objective To explore the value of improved emergency nurse＇s process in the management of PIC easy access for patients with chest pain. Methods 112 patients with AMI were divided into two groups： one was admitted from January to June 2015 as the control group and the other was from January to December,2016 as the observation group. In the control group（ n = 56）,the nurse used the old emergency patients dispersal process and in the observation（ n = 56）,the nurse used the optimized emergency patients dispersal process. The two groups were compared in terms of visiting time,onset time,ECG time,blood drawing time and report time for troponin examination,the total time of imparting the department of cardiology the hospitalization,DAPT drug time,conversation beginning time,informed consent signing time,catheter team imparting time and arriving time,transport imparting time and arriving time,and analyzed average time and the qualified rate of D-to-B. Results The total time of imparting the department of cardiology the hospitalization,DAPT drug time,conversation beginning time,informed consent signing time,catheter team imparting time and arriving time,transport imparting time and arriving time of the observation group was significantly shorter than that of the control group（ P〈 0. 05）. The average time of D-to-B was significantly shorter than that of the control group,but the qualification rate was significantly higher than that of the control group（ P〈 0. 05）. Conclusion Emergency patients dispersal can significantly shorter several timings of PCI easy access for patients with chest pain and improve the qualification rate of D-to-B.