18家社区医院急诊抢救单元的建设现状与改进建议

Construction of emergency rescue units in 18 community hospitals and corresponding recommendations for improvement

目的 :了解社区医院急诊抢救单元建设情况,分析提高急诊抢救水平策略。方法 :采用问卷调查法,对浙江省绍兴市上虞行政区内18家社区医院进行现况调查,包括医务人员一般情况、抢救单元基本设施、急救技术开展情况以及急诊流行性病学工作情况4个方面,描述现况和问题,探讨改进建议。结果 :被调查的18家医院急诊抢救单元中护士共78名,医护比为1∶0.7;抢救单元设备老化、抢救技术不够先进;5家医院开放急诊床位、4家医院配备抢救室、6家医院开展了机械通气和容量复苏、3家医院开展了心外起搏治疗;有10家医院开展了基本急救常识宣传,其他的社区急诊流行性病学工作基本有待开展。结论 :上虞区社区医院急诊抢救单元建设有待进一步提高,存在人力和物力资源不足、抢救知识需要更新等问题,亟待加大必要的人力和物力支持,并加强对现有医务人员急救新知识和新技能培训,从根本上完善社区医院急诊抢救单元建设,提高急诊抢救水平。

Objective： To strengthen construction of emergency rescue units in community hospitals and improve their emergency rescue service. Methods： Totally 18 community hospitals located in Shangyu District of Shaoxing City of Zhejiang province were included to conduct a cross-sectional investment using questionnaires, which contained four dimensions, namely general information of medical staff, fundamental facilities equipped in emergency rescue units, utilization of first aid technologies and epidemiology-related work in emergency departments. Current construction and problems of those invested units were depicted through percentages and constituent ratios. And recommendation for improvement were then proposed through discussion. Results： Nurses in the 18 hospitals surveyed accounted for 78 totally in number with the doctor nurse ratio being 1：0.7. Equipment aging was found in those emergency rescue units with first aid technologies far from being advanced. Of all the hospitals included, five provided open emergency beds, four were equipped with rescue rooms, six were able to employ mechanical ventilation and capacity recovery technologies, three offered cardiac pacing therapy and ten had promoted popularization of basic first aid information, while epidemiology-related work in other community emergency departments were still to be started. Conclusion： The construction of emergency rescue units of community hospitals in Shangyu District is not optimistic with a lack of manpower and material resources as well as necessities of emergency knowledge updating, meaning further improvement is inevitable. It is quite urgent that necessary support of manpower and material resources should be offered as well as enhanced training to emergency staff on new emergency knowledge and rescuing skills for the sake of fundamentally improving the construction of emergency rescue units in community hospitals and providing better emergency rescue service to patients.