CAJ | 학술논문

目的了解急诊抢救室危重患者的分流特征和影响因素,为改善患者的分流提供依据.方法回顾性分析一家大型综合性医院2010年急诊抢救室危重患者的信息,分析患者分流的整体状况,并比较不同主诊科室、不同去向患者的分流状况,比较工作日与周末分流患者的特征,以及一天内不同时段分流患者的特征.结果 (1) 7966例危重患者从抢救室分流所需的中位数时间为11h,超过57.9％的患者分流所需的时间大于6h,23.1％的患者分流时间大于24h.(2)不同主诊科室患者的分流速度有差异,由快到慢依次为其他科室、急诊科、神经外科、神经内科和普通内科.(3)不同分流去向患者的分流速度有差异,其中直接住院和自动出院患者分流所需的时间最长,接受急诊手术且收住ICU的患者分流最快.(4)工作日与周末及一天内不同时段分流的危重患者在科室构成、分流去向、分流所需的时间上均存在差异.结论该家综合性医院急诊抢救室的危重患者分流状况不够理想,影响的因素包括主诊科室不同、分流去向、病情的急迫程度、时间段以及医院住院患者的出院方式等,值得进一步的研究.
목적 료해급진창구실위중환자적분류특정화영향인소,위개선환자적분류제공의거.방법 회고성분석일가대형종합성의원2010년급진창구실위중환자적신식,분석환자분류적정체상황,병비교불동주진과실、불동거향환자적분류상황,비교공작일여주말분류환자적특정,이급일천내불동시단분류환자적특정.결과 (1) 7966례위중환자종창구실분류소수적중위수시간위11h,초과57.9％적환자분류소수적시간대우6h,23.1％적환자분류시간대우24h.(2)불동주진과실환자적분류속도유차이,유쾌도만의차위기타과실、급진과、신경외과、신경내과화보통내과.(3)불동분류거향환자적분류속도유차이,기중직접주원화자동출원환자분류소수적시간최장,접수급진수술차수주ICU적환자분류최쾌.(4)공작일여주말급일천내불동시단분류적위중환자재과실구성、분류거향、분류소수적시간상균존재차이.결론 해가종합성의원급진창구실적위중환자분류상황불구이상,영향적인소포괄주진과실불동、분류거향、병정적급박정도、시간단이급의원주원환자적출원방식등,치득진일보적연구.
Objective To investigate the characteristics of patient throughput in emergency room (ER),and the factors causing increase in ER length of stay in order to improve the quality of emergency service.Methods Data of critically ill patients presented to an emergency room in a tertiary teaching hospital in 2010 were retrospectively studied,and the characteristics of patient throughput including patients referred to different departments with different outcomes,and variation in number of patients round the clock in workdays and weekends were analyzed.Results ( 1 ) The median length of stay (LOS) of 7966 critical patients in emergency room (ER) was 11 h,and of them,56.6％ stayed in ER for more than 6 h,and 21.6％ over 24 h.(2) There were significant differences in LOS in ER among patients treated by different departments leading to no shorter length of time consumed for treatment by many departments other than the following specialties of emergency department,neurosurgery,neurology and general medicine department in sequence from less time required to the longest length of time consumed.( 3 ) There were significant differences in LOS in ER among patients with different courses after disposition leading to the longest length of time consumed by those discharged by patients 'own decision and admitted into the hospital,and the shortest time required in patients after emergency operation.(4) There were also significant differences in specialty,outcomes and time needed for throughput between workdays and weekends,and during different time intervals round the clock.Conclusions The situation of patient throughput of critical illness in emergency room in this hospital was not ideal.The factors associated with prolonged stay in ER included different specialties in charge of patients,different courses and outcomes after disposition,severity of illness,different time intervals round the clock,and this investigation deserves a further study.