体外膜肺氧合患者安全院际转运方案的构建及实施

Construction and application of safe interhospital transport scheme for patients receiving extracorporeal membrane oxygenation

目的构建体外膜肺氧合(ECMO)支持患者安全院际转运方案,并探讨其临床应用效果。方法将2018年7月至2019年7月行ECMO院际转运患者30例设为对照组,按照常规转运流程实施转运;2019年10月至2020年10月的30例患者设为观察组,在常规院际转运流程基础上,基于循证构建并应用ECMO安全院际转运方案进行转运。比较安全院际转运方案实施前后重症医学科医护人员ECMO院际转运知识知晓得分、院际转运效率、院际转运相关不良事件发生率。结果实施后重症医学科医护人员对ECMO院际转运知识得分显著高于实施前,观察组管路预充时间与置管时间显著低于对照组(P<0.05,P<0.01),院际转运相关不良事件发生率低于对照组,但差异无统计学意义。结论安全院际转运方案可提高医护人员院际转运知识掌握程度,提高院际转运效率,减少院际转运相关不良事件的发生率。

Objective To establish a safe interhospital transport scheme for patients receiving extracorporeal membrane oxygenation(ECMO),and to explore its clinical application effect.Methods A safe interhospital transport scheme for patients receiving ECMO was constructed.A total of 60 patients receiving ECMO in need of interhospital transport were enrolled for the non-concurrent controlled trial,and divided into a control group(spanning from July 2018 through July 2019,interhospital transport conducted wi-thout the scheme),and an intervention group(spanning from October 2019 through October 2020,interhospital transport conducted with the scheme).Pre-and-post differences in medical staffers′ECMO knowledge score and changes in efficiency of interhospital transport,and incidence rates of complications related to interhospital transport between the two groups,were compared.Results Medical staffers′ECMO knowledge scores measured post-implement of the scheme were significantly higher than those mea-sured pre-implement.The time for catheter prefilling and catheterization,in the intervention group was significantly shorter than in the control group(P<0.05,P<0.01).The incidence rate of adverse events related to transport in the intervention group was lo-wer than in the control group,though of no significant difference.Conclusion The safe interhospital transport scheme can improve the knowledge level of staffers involved in interhospital transport,enhance the efficiency of interhospital transport,and reduce the incidence rate of adverse events related to interhospital transport.