民营医疗机构医师心肺复苏质量现状调查及心肺复苏考核方式的评价

Investigation on the quality of cardiopulmonary resuscitation of physicians in private medical institutions and evaluation of assessment methods for cardiopulmonary resuscitation

目的了解民营医疗机构心肺复苏质量,评估流程核查评分表及无线模拟报告考核方法优点及不足。方法由佛山市南海区卫生与计划生育局选取该区民营机构医师122人,根据随机数字表法分为A、B两组,两组均由不同医院考官进行30:2单人心肺复苏考核,采用心肺复苏流程核查评分表及挪度小安妮QCPR模型挪度无线报告系统进行考核。结果 (1)医师对心脏骤停心肺复苏流程基本熟悉(两组分数为85.1分及78.5分),但流程核查评分表计分带有主观性,不同考官得出评分有差异,差异无统计学意义(P> 0.05);(2)大部分医师心肺复苏为低质量心肺复苏(系统评分低于75分)(A组47.2分,B组49.0分),其中按压时间占比过低(A组54.35%,B组54.85%)、按压频率过快和过慢(A组65.57%,B组67.21%)、成功通气比例低(A组3.1次/min,B组2.9次/min)、过度通气(A组34.98%,B组42.12%)是主要原因;(3)无线报告考核系统更客观便捷反应复苏质量,心肺复苏流程核查评分表联合挪度无线报告系统能更全面的评估心肺复苏质量。结论民营医疗机构心肺复苏质量相对较差,应加强心肺复苏考核方式,提高心肺复苏抢救成功率。

Objective To understand the quality of cardiopulmonary resuscitation （CPR） in private medical institutions,the merits and demerits of assessment process checklist and wireless simulation report. Methods From the Nanhai District Health and Family Planning Bureau of Foshan City, 122 physicians from private institutions in the district were selected.The random number method was divided into group A and B groups. Both groups were assessed with 30：2 CPR by examiners from different hospitals. The CPR flow checklist and wireless reporting system of small displacement Anne QCPR model were used to assess the two groups. Results （1）Doctors are familiar with the cardiopulmonary resuscitation process （two groups are 85.1 points and 78.5 points）,However,the score of the process verification scale was subjective,and there was no significant difference between the scores obtained by different examiners （P 〉 0.05）;（2） Most physicians had low-quality CPR （system score below 75）（47.2 in group A and 49.0 in group B）,the main reasons were low compression time （54.35% in group A and 54.85% in group B）,fast and slow compression frequency （65.57% in group A and 67.21% in group B）,low successful ventilation rate （3.1 times/min in group A,2.9 times/min in group B） and excessive ventilation （34.98% in group A and 42.12% in group B）.（3）Radio report assessment system more objective and convenient response to the quality of recovery, cardiopulmonary resuscitation process cheek score table combined with Laerdal wireless reporting system can more fully assess the quality of eardiopulmonary resuscitation. Conclusion The quality of eardiopulmonary resuscitation in private medical institutions is relatively poor.The cardiopulmonary resuscitation assessment method should be strengthened to improve the success rate of cardiopulmonary resuscitation.