链式管理流程在急诊脑卒中溶栓绿色通道中对患者急诊服务时限及工作衔接情况的影响

Effect of Chain Management Process on the Time Limit and Work Connection of Emergency Services in the Green Channel of Thrombolysis in Emergency Stroke

目的链式管理流程以单个的环节为管理对象,将内部横向和纵向的每一个管理环节串联在一起,以保证救治工作的有效性和连续性,但目前链式管理流程在国内应用尚不成熟,故本研究旨在探析链式管理流程在急诊脑卒中溶栓绿色通道中对患者急诊服务时限及工作衔接情况的影响。方法选取肇庆市第一人民医院2018年3月-2020年3月收治的脑卒中患者共60例,按照其在急诊脑卒中溶栓绿色通道中采取的流程分为对照组(n=30,采取常规急救流程)和观察组(n=30,采取链式管理流程)。对比两组患者急诊服务时限(包括院前急救完成病史采集和初步评估病情的时间、就诊至院内完成体格检查和再次评估病情的时间、就诊至完成脑部CT检查并出结果的时间、就诊至进行溶栓治疗的时间)和急救工作衔接情况(提前通知相关科室待命率、提前准备抢救设备率、交接时告知病情率)。结果观察组急诊服务时限均短于对照组,两组对比差异具有统计学意义(P<0.05);观察组急救工作衔接情况均优于对照组,两组对比差异具有统计学意义(P<0.05)。结论链式管理流程在急诊脑卒中溶栓绿色通道中可以缩短院急诊服务时限,改善急救工作衔接情况,值得进一步应用。

Objective The chain management process takes a single link as the management object and connects each internal horizontal and vertical management link in series to ensure the effectiveness and continuity of treatment.However,the application of the chain management process in China is not mature at present.Therefore,this study aims to explore the effect of the chain management process on patients’emergency service in the green channel of emergency stroke thrombolysis and the impact of service time limit and work connection.Methods A total of 60 stroke patients in our hospital from March 2018 to March 2020 were selected,and according to the process adopted in the green channel of emergency thrombolysis for stroke,they were divided into control group(n=30,taking the routine first aid process)and observation group(n=30,taking the chain management process).The emergency service time limit of the two groups was compared(including the time from pre-hospital first aid to complete medical history collection and preliminary assessment of the patient’s condition,the time from medical treatment to hospital physical examination and reassessment of the patient’s condition,the time from medical treatment to brain CT examination and results,and the time from medical treatment to thrombolytic treatment)and the connection of first aid work.Results The time limit of emergency service in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05);the connection of emergency work in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The chain management process in the green channel of thrombolysis in emergency stroke can shorten the time limit of hospital emergency service and improve the connection of emergency work,which is worthy of further application.