CAJ | 학술논문

目的：分析北京协和医院急诊分诊过程中的分诊缺陷案例发生原因，找出相应的对策，为进一步完善急诊分诊体系提供依据。方法选择2013年8—12月，初次就诊患者为研究对象，分诊后9 h 内被转入抢救室者被定为分诊缺陷。采用自行设计急诊分诊量表，内容包括患者的一般资料、来诊时的资料、分诊级别、分科、处理措施以及患者的转归、医疗资源使用量等诊疗资料。结果研究对象中，分诊为1，2级的23例患者出现分诊缺陷，其中10例由于抢救室过度拥挤未能及时转入到抢救室，11例因检验异常后转入到抢救室，8例患者症状加重转入到抢救室。结论急诊区域拥挤程度影响分诊标准实施；通过即时检验（POCT）进行检查尽量移至分诊台，关注容易导致病情加重的症状，并及早给予干预；分诊评估标准应包含专科评估内容，同时关注门诊转急诊科患者的病情。
목적：분석북경협화의원급진분진과정중적분진결함안례발생원인，조출상응적대책，위진일보완선급진분진체계제공의거。방법선택2013년8—12월，초차취진환자위연구대상，분진후9 h 내피전입창구실자피정위분진결함。채용자행설계급진분진량표，내용포괄환자적일반자료、래진시적자료、분진급별、분과、처리조시이급환자적전귀、의료자원사용량등진료자료。결과연구대상중，분진위1，2급적23례환자출현분진결함，기중10례유우창구실과도옹제미능급시전입도창구실，11례인검험이상후전입도창구실，8례환자증상가중전입도창구실。결론급진구역옹제정도영향분진표준실시；통과즉시검험（POCT）진행검사진량이지분진태，관주용역도치병정가중적증상，병급조급여간예；분진평고표준응포함전과평고내용，동시관주문진전급진과환자적병정。
Objective To analyze the reason of triage shortcomings for 23 emergency critical patients,find out the countermeasure and provide an evidence to further perfect emergency triage system. Methods Patients visited our emergency department first from August to December 2013 were analyzed,who transferred from the admission room to resuscitation room within 9 hours classified as triage shortcomings. Self-designed scale were used to collect clinical data including general information,admitted information,triage levels,branch,treatment measures,Prognosis of disease,usage of medical resources,etc. Results In the object of study,the triage level as level 1 and 2 of 23 cases performed triage shortcomings,in which 10 cases of them could not transfer to Resurrection Room(RR)because of crowed RR,11 cases of them transfered to RR after abnormal inspect,and 8 cases transferred to RR because of symptom deterioration. Conclusions The implement of triage maybe influenced by the crowd of emergency room and POCT was suggested to perform for some patients in the triage desk. Life threaten symptoms should be monitored,and be treated in the early stage. Disease evaluation should include professional assessment contents and patient's condition was paid attention on when they transferred to Emergency Department.