预警分级管理对危重早产儿院内转运时间及不良事件发生的影响

Effect of early warning and graded management on hospital transit time and adverse events of critical premature infants

目的探究预警分级管理对危重早产儿院内转运时间及不良事件发生情况的影响,以期改善患儿的临床结局。方法选择2019年3-6月的40例危重早产儿为对照组,2019年7-10月的40例危重早产儿为观察组。对照组采用常规转运方法,观察组在常规转运方法的基础上采用预警分级管理方法转运,记录并比较2组患儿的转运时间、转运不良事件发生率以及不良结局发生率。结果观察组的转运时间为(12.29±2.14)min,明显低于对照组的转运时间(18.65±3.37)min(P<0.05);观察组转运不良事件发生率为2.50%(气管插管脱出1例),明显低于对照组的转运不良事件发生率(20.00%,气管插管脱出、静脉置管堵塞、监护仪导联松脱各2例,供氧不足、仪器设备故障各1例,P<0.05);观察组不良结局发生率为7.50%(呼吸异常、低体温、低血氧饱和度各1例),明显低于对照组的不良结局发生率(47.50%,呼吸异常、心率异常各4例,低体温5例,低血氧饱和度6例,P<0.05)。结论预警分级管理指导危重早产儿院内转运具有较好的效果,不仅能有效减少转运时间、降低不良事件的发生率,还能改善早产儿结局。

Objective To explore the effect of early warning and graded management on hospital transit time and adverse events of critical premature infants, so as to improve the clinical outcomes of patients. Methods A total of 40 critical premature infants from March to June, 2019 were selected as control group and 40 critical premature infants from July to October, 2019 as observation group. The control group was transported by conventional transfer method, while the observation group was transported by early warning and grading management method on the basis of the conventional transport method. The transit time, incidence of adverse events and incidence of adverse outcomes were recorded and compared between the two groups. Results The transit time of the observation group was(12.29±2.14) min, which was evidently lower in comparison with the control group(18.65±3.37) min(P<0.05). The occurrence rate of adverse events was 2.50%(1 case of tracheal intubation disconnection) in the observation group, which was obviously reduced in contrast to the control group(20.00%;2 cases of tracheal intubation disconnection, 2 cases of venous catheter blockage, 1 case of oxygen deficiency, 2 cases of monitor lead disconnection, and 1 case of instrument failure), P<0.05. The occurrence rate of poor outcomes was 7.50%(1 case of abnormal breathing, 1 case of hypothermia and 1 case of hypoxia) in the observation group, which was visibly lower than the control group(47.50%;4 cases of abnormal breathing, 4 cases of abnormal heart rate, 5 cases of hypothermia and 6 cases of hypoxia), P<0.05. Conclusion Early warning and graded management has a good effect on in-hospital transport of critically ill premature infants, which can not only effectively shorten transit time, reduce the incidence of adverse events, but also improve the outcomes of premature infants.