目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受...目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)评价模型预测效果。结果英国国家早期预警评分(national early warning score,NEWS)、血氧饱和度、急诊B超、血管活性药物、机械通气是急诊科危重症患者发生病情不良事件的独立风险因素;血氧饱和度、携氧装置、Ⅲ类管路、护工参与转运是技术不良事件的独立风险因素(均P<0.05)。AUC分别为0.813,0.756。结论构建的急诊科危重症患者院内转运不良事件风险预测模型具有一定的参考价值。展开更多
BACKGROUND:In Hong Kong, the reorganization of healthcare frame work for better utilization of resources has led to an increase in the frequency of inter-facility transport in recent years. An Inter-Facility Transpor...BACKGROUND:In Hong Kong, the reorganization of healthcare frame work for better utilization of resources has led to an increase in the frequency of inter-facility transport in recent years. An Inter-Facility Transport Triage Guideline (IFTTG) was introduced and evaluated on its compliance and performance. This study aimed to evaluate the compliance to the IFTTG and performance of inter-facility transport after the IFTTG was implemented. METHODS: The patients who required emergency IFT with accompanying personnel in two consecutive periods (pre-implementation period: January 1,2006 to April 30, 2006; post-implementation period: May 1,2006 to August 31,2006) were included. The compliance to pre-transport triage and transport team configuration was evaluated by a review panel with eight performance indicators identified. The performance indicators were compared individually and as an overall score. RESULTS:Sixty-eight (26 in the pre-implementation period and 42 in the post-implementation period) IFTs were reviewed. There was demonstrable improvement on compliance to the IFTTG. The appropriateness of pre-transport triage increased from 34.6% to 54.8% whereas appropriateness of transport team configuration rose significantly from 73.1% to 92.9% (P〈0.05). Staff performance on individual IFT performance indicator was satisfactory in both periods and the means of overall score on performance indicators were 7.12 and 7.29 respectively. The most improved performance indicator was the appropriateness of transport team configuration. CONCLUSIONS: The compliance and performance with the newly implemented IFTTG were satisfactory. However, staff comment and satisfaction with the use of the new guideline should be collected so as to achieve continuous quality improvement.展开更多
文摘目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)评价模型预测效果。结果英国国家早期预警评分(national early warning score,NEWS)、血氧饱和度、急诊B超、血管活性药物、机械通气是急诊科危重症患者发生病情不良事件的独立风险因素;血氧饱和度、携氧装置、Ⅲ类管路、护工参与转运是技术不良事件的独立风险因素(均P<0.05)。AUC分别为0.813,0.756。结论构建的急诊科危重症患者院内转运不良事件风险预测模型具有一定的参考价值。
文摘BACKGROUND:In Hong Kong, the reorganization of healthcare frame work for better utilization of resources has led to an increase in the frequency of inter-facility transport in recent years. An Inter-Facility Transport Triage Guideline (IFTTG) was introduced and evaluated on its compliance and performance. This study aimed to evaluate the compliance to the IFTTG and performance of inter-facility transport after the IFTTG was implemented. METHODS: The patients who required emergency IFT with accompanying personnel in two consecutive periods (pre-implementation period: January 1,2006 to April 30, 2006; post-implementation period: May 1,2006 to August 31,2006) were included. The compliance to pre-transport triage and transport team configuration was evaluated by a review panel with eight performance indicators identified. The performance indicators were compared individually and as an overall score. RESULTS:Sixty-eight (26 in the pre-implementation period and 42 in the post-implementation period) IFTs were reviewed. There was demonstrable improvement on compliance to the IFTTG. The appropriateness of pre-transport triage increased from 34.6% to 54.8% whereas appropriateness of transport team configuration rose significantly from 73.1% to 92.9% (P〈0.05). Staff performance on individual IFT performance indicator was satisfactory in both periods and the means of overall score on performance indicators were 7.12 and 7.29 respectively. The most improved performance indicator was the appropriateness of transport team configuration. CONCLUSIONS: The compliance and performance with the newly implemented IFTTG were satisfactory. However, staff comment and satisfaction with the use of the new guideline should be collected so as to achieve continuous quality improvement.