医务人员视角下急性缺血性脑卒中院内救治模式优化的质性研究

Optimization of in-hospital treatment mode among patients with acute ischemic stroke from medical staff's perspective:a qualitative study

目的了解医务人员对急性缺血性脑卒中(acute ischemic stroke,AIS)院内救治模式的看法以及该模式可优化的要素,为进一步优化AIS院内救治模式提供依据.方法 2017年11月-2018年1月,采用目的抽样法从海军军医大学附属长海医院AIS院内救治团队中选取15名作为访谈对象,应用半结构化访谈法对其进行访谈,通过笔录及录音采集数据,采用Colaizzi内容分析法进行资料分析.结果医务人员对AIS院内救治模式优化的体验包括5个主题:(1)AIS院内救治模式基本合理;(2)介入治疗团队预警前移的需求;(3)脑卒中急救专科护理队伍建设的需求;(4)信息化助力AIS救治流程监管的需求;(5)院前预警的需求.结论有必要进一步提前预警介入治疗团队做好术前准备,建设脑卒中急救专科护理队伍进行全程引导与质控,促进院前、院内救治一体化以尽快激活院内救治系统,完善AIS救治信息化建设以助力救治效率监管,进一步缩短AIS院内救治时间.

Objective To explore medical staff's attitude towards in-hospital treatment mode among patients with acute ischemic stroke(AIS),and the optimizable factors of the mode,so as to provide reference for further optimization of the treatment mode. Methods From November of 2017 to January of 2018, 15 medical staff from the AIS team in Changhai Hospital Affiliated to the Second Military Medical University were selected by purposive sampling and interviewed by semi-structured interviewing method. Data was collected in the way of handwriting and recording. Colaizzi data analysis was used to analyze the materials. Results The experience of medical staff in optimizing the treatment mode of AIS hospital included five themes:(1)the treatment mode of AIS hospital was basically reasonable;(2)the need for early warning of neurointerventional treatment team;(3)the need for the construction of specialist nursing team for the emergency treatment of stroke;(4)the need for supervision of the treatment process of AIS by information technology;(5)the need for pre-hospital warning. Conclusions It is necessary to make preparations in advance for invasive treatment team, construct the specialist stroke first aid nursing team for the whole process guiding and quality control, promote the integration of pre-hospital and in-hospital treatment so as to activate the in-hospital treatment system as soon as possible, improve the construction of AIS treatment informatization in order to assist the supervision of treatment efficiency, and further shorten the time of in-hospital treatment of AIS.