体外膜肺氧合支持患者院际标准化转运方案的构建与应用

Construction and application of an interhospital standardized transport scheme for patients supported by extracorporeal membrane oxygenation

目的基于流程再造理论,结合改良早期预警评分(MEWS)及转运核查单构建体外膜肺氧合支持(ECMO)患者院际标准化转运方案,并评价实施效果。方法通过文献回顾,根据郑州大学第二附属医院实际情况将MEWS评分与转运核查单有效结合,构建ECMO患者院际标准化转运方案,并根据院际标准化转运方案对转运小组医护人员进行ECMO患者转运知识培训与考核。采用便利抽样法,将2019年1—12月郑州大学第二附属医院收治的采用常规转运方式进行转运的223例ECMO患者为对照组,将2020年1—12月收治的采用ECMO院际标准化转运方案进行转运的222例ECMO患者为观察组。比较两组患者转运不良事件的发生率及培训前后转运小组医护人员ECMO患者转运知识得分。结果培训后医护人员ECMO患者转运知识得分高于培训前,差异有统计学意义(P<0.01);观察组患者转运不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论ECMO患者院际标准化转运方案能够形成高效、安全地标准化转运流程,降低转运不良事件发生率,提高ECMO患者转运安全性。

Objective To construct an inter-hospital standardized transport scheme for patients supported by extracorporeal membrane oxygenation(ECMO)combined with modified early warning score(MEWS)and the transport checklist based on the theory of process reengineering.Methods Through literature review,according to the actual situation of the Second Affiliated Hospital of Zhengzhou University,the MEWS scores and transport verification sheets were effectively combined to construct the inter-hospital standardized transport scheme for patients supported by extracorporeal membrane oxygenation.And according to the inter-hospital standardized transport scheme,the medical staff in the transport team were trained and assessed for ECMO patient transport knowledge.Using the convenient sampling method,a total of 223 ECMO patients admitted to the Second Affiliated Hospital of Zhengzhou University from January to December 2019 who were transported by conventional transport were selected as the control group.A total of 222 ECMO patients who were transported by the ECMO interhospital standardized transport scheme from January to December 2020 were selected as the observation group.This study Compared the incidence of adverse transport events in the two groups of and the transport knowledge of medical staff in the transport group before and after training.Results The score of transport knowledge of ECMO patients of medical staff after training were higher than those before training,and the difference was statistically significant(P<0.01).The incidence of transport adverse events in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions The standardized inter-hospital transport scheme for ECMO patients can form an efficient and safe standardized transport process,reduce the incidence of adverse transport events and improve the transport safety of ECMO patients.