河南省急诊科护士对创伤患者低体温的院内管理现状

Current Situation of in Hospital Management of Hypothermia in Trauma Patients Among Emergency Department Nurses in Henan Province

目的 调查河南省急诊创伤患者低体温院内管理现状,为临床护理管理制定规范流程提供参考依据。方法 采用便利抽样法,对河南省53所医院急诊科的392名护理人员进行调查。结果 53所医院有39所医院成立了创伤中心;在392名研究对象中,79.8%的护士会在接诊创伤患者时评估体温;76.0%的护士会在患者入院时立即测量体温;6.9%的护士测量耳温;57.1%的护士会根据患者情况选择测量频率;分别有28.1%、71.2%、49.7%的护士选择使用升温毯、提高室温、加温输液对低体温患者进行复温;77.3%的护士会对复温患者进行观察;24.5%的护士在进行体格检查时不会大面积暴露患者;是否成立创伤中心对低体温评估、复温管理方面比较,差异有统计学意义(P<0.05)。结论 急诊科护士对创伤患者体温评估有所提高,但在监测和复温管理方面仍有待提高,管理者在创伤中心建设中要积极开展低体温相关知识的培训,更新理念,引进有效的设备,提高临床工作效率,完善创伤患者低体温的救治管理水平。

Objective To investigate the present situation of in hospital management of hypothermia in trauma patients among emergency department nurses in Henan province,so as to provide reference for establishing a standardized process for clinical management.Methods A total of 392 nurses were selected from the Emergency Department of 53 hospitals in Henan province by convenience sampling method.Results Among the 53 hospitals,39 has estabilshed a trauma center.Among the 392 nurses,79.8%of the nurses would assess temperature when receiving trauma patients,76.0%of the nurses would take the temperature immediately,6.9%of the nurses would measure the ear temperature of trauma patients,57.1%of the nurses would choose the measurement frequency based on the patient’s condition.28.1%,71.2%,49.7%of the nurses would use heating blanket,increase the indoor temperature,heated fluid to rewarm the patients with hypothermia after trauma,respectively.77.3%of the nurses would observe the rewarming patients,24.5%of the nurses do not expose patients extensively during physical examinations.There were statistical differences in hypothermia assessment and active rewarming between hospitals with a trauma center and those without(P<0.05).Conclusion Emergency department nurses have improved their assessment of the temperature of trauma patients,but there is still room for improvement in monitoring and rewarming management.In the construction of trauma centers,managers should actively carry out training on hypothermia related knowledge,update their concepts,introduce effective equipment,improve clinical work efficiency,and improve the treatment and management level of hypothermia in trauma patients.