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1. 南昌大学研究生院护理学院
2. 深圳市第七人民医院护理部
纸质出版日期:2017,
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韩双双, 甘雨霞, 牟园芬. 基于改良早期预警评分的监护方案联合现况-背景-评估-建议模式在心内科的应用[J]. 重庆医科大学学报, 2017,42(9):1183-1187.
Han Shuangshuang, Gan Yuxia, Mou Yuanfen. Application of monitoring method based on modified early warning score combined with situation-background-assessment-recommendation pattern in cardiology department[J]. Journal of Chongqing Medical University, 2017,42(9):1183-1187.
韩双双, 甘雨霞, 牟园芬. 基于改良早期预警评分的监护方案联合现况-背景-评估-建议模式在心内科的应用[J]. 重庆医科大学学报, 2017,42(9):1183-1187. DOI: 10.13406/j.cnki.cyxb.001205.
Han Shuangshuang, Gan Yuxia, Mou Yuanfen. Application of monitoring method based on modified early warning score combined with situation-background-assessment-recommendation pattern in cardiology department[J]. Journal of Chongqing Medical University, 2017,42(9):1183-1187. DOI: 10.13406/j.cnki.cyxb.001205.
目的:探索早期识别心内科患者潜在危重病的程序化监护方案
建立病情早期预警工作流程以及科学有效、规范统一的医护沟通模板。方法:选取2014年10月至2016年2月入住我院心内科的210例患者
随机分为2组
观察组采取基于改良早期预警评分(modified early waring score
MEWS)的程序化监护方案联合现况-背景-评估-建议(situation-background-assessment-recommendation
SBAR)沟通模式;对照组采取传统的监护汇报方案
观察14 d
比较2组意外事件发生率、入住ICU率、医患满意率、护士对患者病情"十知道"知晓率;分析观察组实施前、实施第7天及实施第14天MEWS值与护理分级的相关性。结果:观察组与对照组意外事件发生率(3.92%vs.18.00%)、入住ICU率(0.00%vs.5.00%)、医患满意率(99.02%、97.06%vs.93.00%、90.00%)及护士对患者病情"十知道"知晓率(91.18%vs.77.00%)比较差异有统计学意义(P<0.05);观察组MEWS值与护理级别呈正相关
且实施前、实施第7天及实施第14天相关系数rs分别为-0.683、-0.724及-0.895(P<0.001)
随着方案的实施
MEWS评分与护理分级的相关性越高。结论:基于MEWS的程序化监护方案联合SBAR模式用于心内科
可早期识别"潜在危重病"
促进医护有效沟通
减少意外事件及入住ICU的发生
提高医患满意率;且MEWS值可为制定护理级别提供参考依据。因此
在心内科建立病情早期预警工作流程以及科学有效、规范统一的医护沟通模板具有较好的应用价值。
Objective:To explore the programmed monitoring method which can identify potential critical illness early in cardiology department
and to establish early warning work process and scientific
effective
standardized
unified health care communication template. Methods:Totally 210 patients hospitalized in cardiology of the 7th People’s Hospital of Shenzhen were selected from October 2014 to February 2016 and were randomly divided into two groups:observation group took programmed monitoring method based on modified early warning score(MEWS) combined with situation-background-assessment-recommendation(SBAR);control group took traditional monitoring program. Patients in two groups were observed for 14 days and the rate of accident event
transferring to ICU
satisfaction degree of two groups were observed. The correlation between MEWS and level of nursing before intervention on day 7 and day 14 was analyzed. Results:There was statistical significance in the rate of accident event(3.92% vs. 18.00% )
transferring to ICU(0.00% vs. 5.00% )
satisfaction of doctors and patients to nurses(99.02%
97.06% vs. 93.00%
90.00% )and nurses’ awareness of the patient’s ‘ten know’(91.18% vs. 77.00% )between observation group and control group(P <0.05);The MEWS value and the nursing level was positively correlated in the observation group
and correlation coefficient before intervention
on day 7 and day 14 were-0.683
-0.724 and-0.895(P <0.001)
with the implementation of the program
the correlation was higher. Conclusion:The application of programmed monitoring method based on MEWS combined with SBAR in cardiology department can identify potential critical illness in the early time
promote effective communication between doctors and nurses
reduce the occurrence of accident and ICU admission
improve the satisfaction rate of doctors and patients to nurses;and the value of MEWS can provide a reference for nursing level. Therefore
the establishment of the disease early warning process combined with scientific
effective
standardized
unified medical communication template has a good application value in cardiology department.
改良早期预警评分程序化监护标准化沟通模式心内科
modified early warning scoreprogrammed monitoring methodssituation-background-assessment-recommendationcardiology department
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