Exploration of the Barriers and Education Needs of Non-Pediatric Hospital Emergency Department Providers in Pediatric Trauma Care

Study Objective: Nine million children are seen in emergency departments each year for traumatic injuries. Eighty percent of these children will be cared for in non-children’s hospital settings. We sought to understand the barriers and opportunities for optimal pediatric trauma care in non-pediatric emergency departments and to define practice-specific educational needs. Methods: This qualitative study consisted of focus groups from rural, regional and urban non-pediatric emergency department sites discussing pediatric trauma care. Groups were homogenous for the provider role and included 8 physician groups and 9 non-physician groups. Focus groups were led by a trained moderator using a discussion guide composed of open-ended questions which covered various topics of pediatric trauma care. Focus groups were audio-taped and later transcribed and the data were analyzed for major themes and key concepts. Results: A total of 107 providers participated in the focus groups (32 physicians and 75 non-physicians). Barriers to provide optimal pediatric trauma care expressed by providers included the lack of pediatric trauma experience, inadequate pediatric trauma training and the lack of confidence with assessment of the pediatric trauma patient. All providers across all types of hospitals indicated a need and interest in training focused on pediatric trauma, but topics covered, and skills needed varied by type of facility. Conclusions: Community emergency room providers indicated a need for pediatric trauma education. Specifically, hands-on training with high-fidelity simulation was identified as the most useful type of training to gain the skills and confidence needed to manage pediatric trauma patients in their emergency departments.

Validation of different pediatric triage systems in the emergency department

BACKGROUND: Triage system in children seems to be more challenging compared to adults because of their different response to physiological and psychosocial stressors. This study aimed to determine the best triage system in the pediatric emergency department.METHODS: This was a prospective observational study. This study was divided into two phases. The fi rst phase determined the inter-rater reliability of fi ve triage systems: Manchester Triage System(MTS), Emergency Severity Index(ESI) version 4, Pediatric Canadian Triage and Acuity Scale(CTAS), Australasian Triage Scale(ATS), and Ramathibodi Triage System(RTS) by triage nurses and pediatric residents. In the second phase, to analyze the validity of each triage system, patients were categorized as two groups, i.e., high acuity patients(triage level 1, 2) and low acuity patients(triage level 3, 4, and 5). Then we compared the triage acuity with actual admission.RESULTS: In phase I, RTS illustrated almost perfect inter-rater reliability with kappa of 1.0(P<0.01). ESI and CTAS illustrated good inter-rater reliability with kappa of 0.8–0.9(P<0.01). Meanwhile, ATS and MTS illustrated moderate to good inter-rater reliability with kappa of 0.5–0.7(P<0.01). In phase II, we included 1 041 participants with average age of 4.7±4.2 years, of which 55% were male and 45% were female. In addition 32% of the participants had underlying diseases, and 123(11.8%) patients were admitted. We found that ESI illustrated the most appropriate predicting ability for admission with sensitivity of 52%, specifi city of 81%, and AUC 0.78(95%CI 0.74–0.81).CONCLUSION: RTS illustrated almost perfect inter-rater reliability. Meanwhile, ESI and CTAS illustrated good inter-rater reliability. Finally, ESI illustrated the appropriate validity for triage system.

Application of emergency severity index in pediatric emergency department

BACKGROUND： The purpose of triage is to identify patients needing immediate resuscitation, toassign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures asappropriate. This study aimed to use emergency severity index （ESI） in a pediatric emergency room.METHODS： From July 2006 to August 2010, a total of 21 904 patients visited the InternationalDepartment of Beijing Children＇s Hospital. The ESI was measured by nurses and physicians, andcompared using SPSS.RESULTS： Nurses of the hospital took approximately 2 minutes for triage. The results of triagemade by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This findingindicated that the nurses are able to identify severe pediatric cases.CONCLUSION： In pediatric emergency rooms, ESI is a suitable tool for identifying severecases and then immediate interventions can be performed accordingly.

The mortality of patients in a pediatric emergency department at a tertiary medical center in China: An observational study

BACKGROUND: The quality of treatment for critically ill children varies widely at different hospitals. This study aimed to analyze the characteristics of mortality in a pediatric emergency department(PED) at a tertiary children's hospital in Guangzhou, China and to investigate the risk factors associated with the mortality.METHODS: The mortality of pediatric patients at the hospital from 2011 to 2013 was retrospectively analyzed using descriptive statistics.RESULTS: Altogether 466 919 patients visited the PED during the period and 43 925 of them were admitted for further observation. In 230 deaths, the ratio of boys to girls was 1.4:1, and their age ranged from 2 hours to 16 years(median, 5 months). The time from admission to death ranged from 0 to 216 hours(median, 1.5 hours). There were 92(40%) patients who died within 24 hours after admission and 104(45.2%) patients who died on arrival. The prominent causes of the deaths were respiratory diseases, neuromuscular disorders, cardiovascular diseases, and sepsis, most of which were ascribed to severe infection. Sixty-five deaths were associated with more than one concomitant problem. The top concomitant problems were congenital malformation, low gestational age, and severe birth asphyxia.CONCLUSIONS: In our center, 40% of the patients in the PED died of fatal acute diseases, and pneumonia was the first leading cause of the deaths. Almost half of the deaths occurred on arrival and the rest were due to end-stage malignant diseases. This study emphasized the importance of prevention of birth deficits by reducing deaths in infants and children.

Screening for asymptomatic chlamydia and gonorrhea in adolescent males in an urban pediatric emergency department

AIM To determine the prevalence of Chlamydia trachomatis(CT) and Neisseria gonorrhea(GC) in young men seeking care in the emergency department(ED) for non-sexually transmitted infection(STI) related symptoms.METHODS This was a prospective, cross-sectional study in an urban ED. The main outcome was the rate of positive CT and GC on urine nucleic acid amplification testing in males aged 16-21 presenting with non-STI related complaints. RESULTS Two hundred and eighty-four patients were enrolled, 271 were included in the final data analysis [age range 16-21, median: 18(quartiles 16-18, 19-21)]. Overall, 17(6.3%, 95%CI: 4%-10%) tested positive for CT and 0%(95%CI: 0%-2%) were found to have GC. The proportion of sexually active subjects was 71%(95%CI: 65%-76%) and 2%(95%CI: 0.6%-4%) reported sex with men. Previous STI testing was reported in 46%(95%CI: 43%-54%) and 13%(95%CI: 8%-20%) of those patients previously tested had a history of STI. Of the patients who tested positive for CT in the ED, 88%(95%CI: 64%-98%) were successfully followed up. CONCLUSION The prevalence of CT infection found by screening was 6.3%. Screening and follow-up from the ED was successful. The findings justify routine STI screening in male adolescents presenting to the ED with non-STI related complaints.

Evaluation of Predictors of Suicidal Re-Attempt in Pediatric Patients in the Emergency Department

Background: Suicidal attempt in children is a serious public health problem. A proper identification of features of suicide-related behavior may help physicians to develop an accurate approach. The aim of this study was to clarify the characteristics of children with poisoning due to suicidal attempt and to determine the risk factors of suicidal re-attempt in the Emergency Department (ED) via a simple questionnaire. Methods: We collected medical data of patients under 18 years who were admitted to our ED with intoxication due to suicidal attempt, retrospectively. General characteristics of patients were evaluated. Patients were divided into 2 groups as 1) High risk: patients with repetitive suicide attempt;2) Low risk: patients with first time suicidal attempt. Results: A total of 57 patients were included in this study. The mean age was 15.91 ± 0.97. Majority of the patients were female (73.7%). Analgesics were the most frequent abused drugs with a ratio of 51.1%. It is determined that the most important variables affecting the risk of suicidal re-attempt are “idea about the suicide” and “purpose”. It was determined that patients with an idea of repetitive suicide (I will try again) and whose purpose was to die (I wish I have died) were in the most risky group with a history of previous suicidal attempt. Conclusion: This study suggests that answers of the pediatric patients to some question have a potential to predict the high risk patients. The risk of suicidal re-attempt may be predicted by the answers given to these questions: 1) What is your idea about suicide? 2) What was your purpose?

Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia

BACKGROUND:The Pediatric Infectious Disease Society(PIDS)and Infectious Disease Society of America(IDSA)published an evidence-based guideline for the treatment of uncomplicated communityacquired pneumonia(CAP)in children,recommending aminopenicillins as the first-line therapy.Poor guideline compliance with 10%–50%of patients admitted to the hospital receiving narrow-spectrum antibiotics has been reported.A new clinical practice guideline(CPG)was implemented in our emergency department(ED)for uncomplicated CAP.The aim of this study was to examine baseline knowledge and ED provider prescribing patterns pre-and post-CPG implementation.METHODS:Prior to CPG-implementation,an anonymous case-based survey was distributed to evaluate knowledge of the current PIDS/IDSA guideline.A retrospective chart review of patients treated in the ED for CAP from January 2015 to February 2017 was performed to assess prescribing patterns for intravenous(IV)antibiotics in the ED at Children’s National Health System pre-and post-CPG implementation.RESULTS:ED providers were aware of the PIDS/IDSA guideline recommendations,with 86.4%of survey responders selecting ampicillin as the initial antibiotic of choice.However,only 41.2%of patients admitted to the hospital with uncomplicated CAP pre-CPG received ampicillin(P<0.01).There was no statistically signifi cant increase in ampicillin prescribing post-CPG(P=0.40).CONCLUSIONS:Providers in the ED are aware of the PIDS/IDSA guideline regarding the first-line therapy for uncomplicated CAP;however,this knowledge does not translate into clinical practice.Implementation of a CPG in isolation did not significantly change prescribing patterns for uncomplicated CAP.

Inflammation-related gene expression profiles of salivary extracellular vesicles in patients with head trauma

At present,there is no reliable biomarker for the diagnosis of traumatic brain injury(TBI).Studies have shown that extracellular vesicles released by damaged cells into biological fluids can be used as potential biomarkers for diagnosis of TBI and evaluation of TBI severity.We hypothesize that the genetic profile of salivary extracellular vesicles in patients with head trauma differs from that in uninjured subjects.Findings from this hypothesis would help investigate the severity of TBI.This study included 19 subjects,consisting of seven healthy controls who denied history of head trauma,six patients diagnosed with concussion injury from an outpatient concussion clinic,and six patients with TBI who received treatment in the emergency department within 24 hours after injury.Real-time PCR analysis of salivary extracellular vesicles in participants was performed using TaqMan Human Inflammation array.Gene expression analysis revealed nine upregulated genes in emergency department patients(LOX5,ANXA3,CASP1,IL2RG,ITGAM,ITGB2,LTA4H,MAPK14,and TNFRSF1A)and 13 upregulated genes in concussion clinic patients compared with healthy participants(ADRB1,ADRB2,BDKRB1,HRH1,HRH2,LTB4R2,LTB4R,PTAFR,CYSLTR1,CES1,KLK1,MC2R,and PTGER3).Each patient group had a unique profile.Comparison between groups showed that 15 inflammation-related genes had significant expression change.Our results indicate that inflammation biomarkers can be used for diagnosis of TBI and evaluation of disease severity.This study was approved by the Institutional Review Board on December 18,2015(approval No.0078-12)and on June 9,2016(approval No.4093-16).

儿科门急诊药房用药指导现状与患者需求调研

目的:对儿科门急诊药房的用药指导需求和现状进行深入调研与分析,并提出相应的规范化管理策略。方法:通过问卷对全国12家省市儿童医院进行调研,应用SPSS 25.0和R4.0.3软件进行统计。结果:18项用药指导的咨询条目中“经常咨询+偶尔咨询”的占比均超过了50%,显示出高度的需求。经常咨询占比排名前五的条目:用药时间注意事项(68.65%)、药品分剂量注意事项(57.24%)、药品贮藏注意事项(47.36%)、用药疗程(46.68%)、特殊剂型用法及注意事项(40.37%)。然而,儿科门急诊药师在实际工作中能够主动提供完全指导的比例相对较低,20项用药指导的各条目做到总能告知的平均占比只有42.19%。执行程度得分前5位的是药品贮藏注意事项(4.63分)、药品特殊使用条件(4.62分)、特殊剂型用法及注意事项(4.38分)、药品分剂量注意事项(4.36分)、用药时间注意事项(4.36分)。得分后五位的是药品的适应证(3.72分)、用药后的不良反应及处理措施(3.69分)、喂药技巧与对策(3.65分)、漏服或吐药后的处理措施(3.50分)、药品口味(3.49分)。初级职称比中级及以上职称做到总能执行的程度更高(OR=0.331~0.635,P<0.05),工作年限越长的药师做到总能执行的程度更高(OR=1.019~1.035,P<0.05)。职称是整体执行程度评分的影响因素(P<0.05),初级职称比中级及以上职称总体执行程度更高。门急诊工作中,在窗口配发药品时进行用药交代是最主要的用药指导形式,占比87.22%。药师未能做到全面指导的原因调查显示,高峰期患者量大,时间有限来不及做到全面指导(86.91%)占比最高。结论:当前儿科门急诊药房的用药指导状况并未满足患者的需求,需要在内容、形式及培训等方面实施规范化管理,以提高服务质量。

北京市某三级口腔专科医院门急诊处方不合理情况分析

目的 点评分析北京大学口腔医学院口腔医院门急诊处方,了解处方质量和临床用药存在的问题,为促进合理用药提供参考。方法 随机抽取2021年7—12月该院门急诊处方6 000张,利用美康合理用药软件进行用药合理性初步筛查,再由药师进行人工复审,采用Excel软件对不合理处方进行分类统计及分析。结果 6 000张处方中,软件初筛不合理处方798张(含药品不合理条目828条),不合理率为13.30%。药师人工复审后确认不合理处方214张(含药品不合理条目219条),不合理率为3.57%,不合理条目类型为用法用量不适宜(112条,51.14%)、诊断描述不全(59条,26.94%)、遴选药品不适宜(15条,6.85%)、书写不规范(14条,6.39%)。不合理条目分布最多的科室为口腔黏膜科,占比50.68%。不合理条目数最多的药品为他克莫司软膏,占比30.59%,主要问题为用药频次不合理(超过规定次数)。结论 医院门急诊处方基本合理,但需关注用法用量、诊断描述等问题。合理用药软件有助于处方点评初筛但无效提醒较多、需定期改进,点评结果需要药师结合医药进展及临床实际情况进行人工审核后最终判定。可通过软件初筛结合人工复审并及时反馈问题、加强超说明书用药管理等手段,加强临床合理用药。

医疗机构门急诊处方信息化审核专家共识

保证医疗机构的合理用药是国家卫生健康委为加强医疗卫生服务综合监管水平做出的重要指示。随着我国医疗水平的快速提升、门急诊就诊规模的不断扩大,处方数量急剧增长,基于合理用药数据库的处方信息化审核系统成为药学服务的重要工具。由北京药学会智慧药学与智能化管理专业委员会、中国老年保健医学研究会合理用药与综合评价分会、中国药师协会区域药学服务促进工作委员会、中国智慧药学联盟共同组织相关医疗机构专家撰写了《医疗机构门急诊处方信息化审核专家共识》。本共识旨在为各级医疗机构所开展的门急诊处方信息化审核工作的规范化提供参考,助力医疗机构构建标准统一、合理用药数据库完善的处方信息化审核系统,提升处方审核准确率和医患接受度,进一步提升我国医疗机构的合理用药水平,促进医院药学服务信息化和智慧化发展。

基于Kaiser模型的灾害脆弱性分析在儿科应急管理中的应用

目的通过Kaiser模型对基层儿科的灾害脆弱性现状进行分析,评估儿科灾害事件风险,以提高应急管理能力。方法基于Kaiser模型,从自然灾害、技术灾害、人员伤害和危险品伤害4类、48种灾害来源调查儿科面临的各类潜在危害,通过对危害风险的分析和风险值排序,明确儿科应急管理的重点,有针对性地强化应急管理的措施,从而健全儿科应急管理体系。结果自然灾害事件中,相对风险值排前5位的依次为地震(34.44%)、暴雨(25.69%)、火灾(23.94%)、极端高温(22.13%)及干旱(15.95%)。技术灾害事件中,相对风险值排前5位的依次为针刺伤(27.62%)、穿刺失败(25.52%)、停水/停电(24.99%)、信息系统故障(24.13%)及电梯意外事件(23.22%)。人员伤害事件中,相对风险值排前5位的依次为“新冠”肺炎院内传播(16.26%)、药物不良反应(15.57%)、跌倒/坠床(12.10%)、暴力伤医事件(11.07%)及误服药物(10.59%)。危险品类事件中,相对风险值排前5位的依次为玻璃体温计断裂(11.77%)、危险气体泄漏(7.89%)、放射性物体泄漏(7.52%)、化学品泄漏(5.40%)及氧气泄漏(5.34%)。全部事件按照风险值由高至低排序,前5位依次为地震(34.44%)、针刺伤(27.62%)、暴雨(25.69%)、穿刺失败(25.52%)及停水/停电(24.99%)。结论Kaiser模型是一种科学有效的应急风险分析工具,为全面保障医疗安全提供了一定参考,对科室应急事件管理有较高的适用性,值得在医院内推广应用。根据灾害脆弱性分析(HVA)结果和报告,应针对暴露的防控薄弱点,修订和完善科室突发事件的应急预案,加强科室应急培训和演练,提高应急反应和医疗保障能力。

数字化技术助力儿科急诊能力提升的实践与思考

针对儿科急救医疗服务体系面临的业务特点、管理模式以及标准化等问题,依托数字化技术,探索建立了一套涵盖院前、院中、院后的儿科急诊全周期管理体系。实践证明,数字化技术对促进儿科急诊能力提升具有重要作用,但应重视医疗数据的有效利用和医疗风险评估,探索建立临床辅助决策体系,关注儿童全周期健康管理。

公立医院价格改革对门急诊次均费用的影响——以绍兴市为例

目的:分析医保市级统筹背景下绍兴市县级以上公立医院医疗服务价格改革对门急诊次均费用的影响。方法:运用结构变动度和灰色关联法,分析改革前后公立医院患者门急诊各项费用结构变动和关联程度。结果:改革前后,疫苗费、中成药费、检查费、手术费、诊察费、治疗费呈现正向变动趋势,化验费、中药饮片费、西药费、卫生材料费、其他费用呈现负向变动趋势。西药费是影响次均费用的主要因素,其次是诊察费、治疗费等。结论:价格改革基本实现了全市范围医疗服务价格的统一,同时未明显增加患者就医和用药负担,医务人员劳务价值得到体现,取得了初步成效,今后对于检查费的结构调整有待进一步加强。

儿科门诊急性上呼吸道感染应用抗菌药物的使用情况

目的探讨儿科门诊中急性上呼吸道感染的抗菌药物使用情况,并评价临床应用效果。方法回顾性研究2023年1月-12月连江县潘渡镇卫生院儿科门诊收治的300例急性上呼吸道感染患儿的临床资料,分析抗菌药物使用情况。结果300张处方中抗菌药物处方188张,使用率为62.67%,其中,一联用药占52.12%,二联用药占30.31%,三联用药占17.55%。在抗菌药物给药途径中,口服给药是首要途径(57.44%),其次是静脉给药(29.25%)。外周白细胞计数正常的处方中,抗菌药物使用率为45.45%,在没有进行血象检查的处方中,抗菌药物使用率17.64%。主要使用抗菌药物5类,其中头孢菌素类最多,而DDDs排第1位的是阿奇霉素,其次是头孢克洛。结论儿科门诊急性上呼吸道感染患儿的抗菌药物使用情况总体较规范,但仍存在一些不合理使用情况,在实际用药中,临床还需加强监督和指导,确保抗菌药物在儿科门诊治疗急性上呼吸道感染中的合理使用。

急诊护理流程优化路径对儿科发热门诊患儿及家长心理弹性、依从性的影响

目的探讨急诊护理流程优化路径在儿科发热门诊患儿中的应用价值。方法选取2021年10月至2022年10月江西省宜春市妇幼保健院采用常规急救护理流程期间儿科发热门诊收治的62例患儿作为对照组,另选取2022年11月至2023年11月江西省宜春市妇幼保健院采用急诊护理流程优化路径期间儿科发热门诊收治的62例患儿作为观察组。比较两组患儿急救效率、家长心理弹性、患儿依从性以及家长满意度。结果观察组急救效率高于对照组,差异有统计学意义(P<0.05)。观察组护理后心理弹性量表(CD-RISC)各项评分均高于对照组,差异有统计学意义(P<0.05)。观察组总依从率高于对照组,差异有统计学意义(P<0.05)。观察组护理后儿童普适性生活质量量表(PedsQL4.0)评分高于对照组,差异有统计学意义(P<0.05)。观察组家长满意度中护患关系、护士操作、服务及时性等维度评分均高于对照组,差异有统计学意义(P<0.05)。结论儿科发热门诊患儿经急诊护理流程优化路径干预后,可提升患儿急救效率,有助于改善家长心理弹性水平,增强患儿依从性,从而提升家长对护理工作的满意度。

智能诊室资源调配系统的开发与应用

门急诊诊室资源分配问题是医院工作人员日常需要处理的问题之一。为提高门急诊患者就诊效率和患者满意度,该文利用大数据平台与人工智能算法技术,设计了一套智能诊室资源调配系统,以优化传统诊室资源调配流程。经上海某三甲医院实际应用后结果显示,该系统能有效提升门急诊就诊效率,优化患者就医体验。

投诉闭环管理在门/急诊管理中对减少患者投诉率的作用

目的探讨投诉闭环管理在门/急诊管理中对减少患者投诉率的作用。方法东莞市肝胆医院/东莞市南城医院于2022年3月执行投诉闭环管理,执行前实施传统投诉管理。对比执行前(2021年3月—2022年2月)与执行后(2022年3月—2023年2月)的门/急诊患者投诉率、各种投诉原因发生率、投诉问题有效处理率。结果执行后,门/急诊患者投诉率低于执行前,但差异无统计学意义(P>0.05)。执行前后制度/流程执行不到位、制度/流程缺陷、服务态度/沟通问题、环境设施问题、收费相关问题、医疗争议/纠纷、其他原因发生率比较,差异无统计学意义(P>0.05)。执行后投诉问题有效处理率为100%,高于执行前的18.18%,差异有统计学意义(P<0.05)。结论在门/急诊管理中应用投诉闭环管理可以降低发生制度/流程执行不到位、制度/流程缺陷、服务态度/沟通问题、环境设施问题、收费相关问题、医疗争议/纠纷、其他原因等各种问题的风险,整体减少患者投诉率,并可以有效处理各种投诉问题。

我院儿科门诊0~12周岁儿童毒性中药处方的回顾性分析

目的 分析我院儿科门诊2022年0~12周岁儿童毒性中药处方的使用情况及特点。方法 回顾性分析2022年我院儿科门诊0~12周岁儿童毒性中药处方的临床资料,并对患儿的年龄、性别、疾病、中药处方、剂量等数据进行统计分析。结果 调查获得处方共计816张,包含12种毒性中药成分。依照《中国药典(2020年版)》中对于毒性中药的描述,有毒中药为炒苍耳子、制草乌以及制川乌,小毒中药为燀苦杏仁、川楝子、蛇床子、艾叶、胆南星、法半夏、细辛、重楼以及蒺藜。这12味毒性药物中大部分为辛、苦药,主要归肺、肝、肾经。在我院儿科门诊816例0~12周岁患儿中,男518例,占比63.48%;女298例,占比36.52%。其中学龄前期(3~6岁)患儿使用含毒性中药处方占比最高,婴儿期患儿占比最低,4岁儿童毒性中药使用率居于第一位。含有毒性中药的处方大部分主治呼吸系统疾病,排名第1位的主要证型为风邪外袭证。在开具的含毒性中药处方中,排名前4位的中药分别是燀苦杏仁、法半夏、炒苍耳子以及细辛。部分药物(总计89例)存在超剂量使用情况,占比10.91%,其中法半夏占比最高。结论 目前,儿科门诊开具的中药处方中含有毒性中药属于普遍现象,但仍需要严格监督其合理使用,应尽量避免在用药过程中出现超药典剂量用药的情况。

心理护理干预在急诊门诊静脉注射患者中的运用效果研究

目的目的探讨急诊门诊静脉注射患者中应用心理护理干预的临床价值。方法方法从院内选取80例急诊门诊静脉注射患者,实施抽签法分组方法,分为探究组、基础组,探究组采取心理护理干预,基础组应用常规护理,比较两组护理前后负性情绪评分、护理依从性、护理满意度。结果结果护理前,探究组负性情绪评分对比基础组,无差异(P>0.05),护理后,探究组负性情绪评分显著低于基础组,有意义(P<0.05),探究组护理依从性高于基础组,有意义(P<0.05),探究组护理满意度相比基础组更高,有意义(P<0.05)。结论结论心理护理干预应用在急诊门诊静脉注射患者中可改善患者不良心理状态,提高患者护理满意度。