CAJ | 학술논문

目的探讨改良早期预警评分(MEWS)在急诊留观患者风险管理中的应用价值.方法通过动态监测MEWS,决定患者处理策略和去向;比较不同流向患者评分的差异;调查医生、护士对实施MEWS管理模式的满意度.结果评分无动态变化的245例患者MEWS为(2.6±1.2)分;有动态变化的44例中,直接收住院的32例患者评分为(4.6±1.7)分;转抢救室12例患者评分为(6.2±2.4)分.各组患者评分比较差异均有统计学意义(2.6±1.2 vs.4.6±1.7,t=3.44,P=0.003;2.6±1.2 vs.6.2±2.4,t=5.10,P=0.000;4.6±1.7 vs.6.2±2.4,t=2.79,P=0.007);医生、护士对实施MEWS动态监测前后的留观患者管理满意度分别为75.5%和94.3%,前后比较差异有统计学意义(χ~2 =7.36,P＜0.01).结论 MEWS可作为急诊留观患者风险管理和合理分流的有效工具,值得临床推广.
목적 탐토개량조기예경평분(MEWS)재급진류관환자풍험관리중적응용개치.방법 통과동태감측MEWS,결정환자처리책략화거향;비교불동류향환자평분적차이;조사의생、호사대실시MEWS관리모식적만의도.결과 평분무동태변화적245례환자MEWS위(2.6±1.2)분;유동태변화적44례중,직접수주원적32례환자평분위(4.6±1.7)분;전창구실12례환자평분위(6.2±2.4)분.각조환자평분비교차이균유통계학의의(2.6±1.2 vs.4.6±1.7,t=3.44,P=0.003;2.6±1.2 vs.6.2±2.4,t=5.10,P=0.000;4.6±1.7 vs.6.2±2.4,t=2.79,P=0.007);의생、호사대실시MEWS동태감측전후적류관환자관리만의도분별위75.5%화94.3%,전후비교차이유통계학의의(χ~2 =7.36,P＜0.01).결론 MEWS가작위급진류관환자풍험관리화합리분류적유효공구,치득림상추엄.
Objective To explore the application value of modified early warning score (MEWS) in the administration of patients in emergency observation ward. Methods Triage criteria were determined by MEWS and the scores were compared among different admission departments.Approval of"MEWS administration model" was investigated in doctors and nurses of emergency department. Results There were significant differences in MEWS among different admission departments,(2.6±1.2) for 245 patients who had no changes in MEWS vs.(4.6±1.7) for 32 hospital admission patients who had the increases in MEWS (t=3.44,P=0.003);(2.6±1.2) vs(6.2±2.4) for 12 emergency rescue room admission patients who also had the increases in MEWS(t=5.10,P=0.000);(4.6±1.7) vs.(6.2±2.4),(t=2.79,P=0.007).Approval of"MEWS administration model"in doctors and nurses of emergency department was 75.5% for non"MEWS administration model" vs. 94.3% for "MEWS administration model" (χ~2 =7.36,P＜0.01). Conclusion MEWS may be popularized in emergency observation ward as a tool of risk administration for the patients.