危重患者院内转运的最佳证据总结

Best Evidence Summary for In-hospital Transport of Critically Ill Patients

目的遴选并获取国内外危重患者院内转运的相关证据,并对最佳证据进行总结。方法使用计算机检索英国医学杂志(the British Journal of Medicine,BMJ)、美国指南网(National Guideline Clearinghouse,NGC)、英国国家医疗保健优化研究所(National Institute for Health and Care Excellence,NICE)、JBI循证卫生保健中心数据库、Cochrane Library、循证医学指南、欧洲医学会(European Society of Intensive Care Medicine,ESICM)、苏格兰学院间指南网(National Integrated Cancer Network Scottish Intercollegiate Guideline,SIGN)、中国生物医学文献数据库、PubMed、中国知网和万方数据库内关于危重患者院内转运的相关证据,证据类型包括临床决策支持、指南、系统评价、证据总结、专家共识。检索时限为建库至2019年7月25日。由2~4名研究员对文献进行独立评价,结合专业人士的判断,对符合标准的文献资料进行提取。结果共纳入15篇文献,其中指南5篇、系统评价5篇、证据总结2篇、专家共识及建议2篇、临床决策支持1篇。最佳证据分别从危重患者院内转运的转运人员资质及培训、转运设备、转运计划、转运沟通、交接记录、转运管理、转运不良事件7个方面进行总结,共59条。结论本研究总结了危重患者院内转运的最佳证据,为危重患者转运提供了循证依据,医务人员应用证据时应结合自身医院及科室的具体情况,有针对性地采用证据。但随着时间的推移,最佳证据会不断更新,应用人员需要对证据进行持续的更新,将证据更好的应用于临床,降低危重患者转运的不良事件发生率。

Objective To select and obtain relevant evidence at home and abroad for the transport of critically ill patients,and to summarize the best evidence.Methods British Journal of Medicine(BMJ),National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Joanna Briggs Institute(JBI)evidence-based Health Care Center Database,Cochrane library,EBM Guidelines,European Society of Intensive Care Medicine(ESICM),National Integrated Cancer Network Scottish Intercollegiate Guideline(SIGN),CBM,PubMed,CNKI and Wanfang Database on Cancer were searched by computer from the inception to July 25 in 2019 for literatures including guidelines,systematic evaluation,best practice information books,evidence summaries and expert consensus.Two researchers evaluated independently the literatures and extracted the documents meeting the standards.Results Fifteen articles were included,including 5 guidelines,5 systematic reviews,2 evidence summaries,2 expert consensus and recommendations,and 1 clinical decision support.The best evidence was summarized from the following seven aspects:transfer personnel qualification and training,transfer equipment,transfer plan,transfer communication,handover record,transfer management,and transport adverse events,the total articles of 59.Conclusion This study summarizes the best evidence for the in-hospital transport of critically ill patients.Medical personnel should apply evidence in combination with the specific conditions of their own hospitals and departments,and use evidence in a targeted manner.However,it is still necessary to apply updated evidence in clinic to reduce the incidence of adverse events in critically ill patients.