【摘要】：目的:探索早期識別心內(nèi)科患者潛在危重病的程序化監(jiān)護方案,建立病情早期預(yù)警工作流程以及科學(xué)有效、規(guī)范統(tǒng)一的醫(yī)護溝通模板。方法:選取2014年10月至2016年2月入住我院心內(nèi)科的210例患者,隨機分為2組,觀察組采取基于改良早期預(yù)警評分(modified early waring score,MEWS)的程序化監(jiān)護方案聯(lián)合現(xiàn)況-背景-評估-建議(situation-background-assessment-recommendation,SBAR)溝通模式;對照組采取傳統(tǒng)的監(jiān)護匯報方案,觀察14 d,比較2組意外事件發(fā)生率、入住ICU率、醫(yī)患滿意率、護士對患者病情"十知道"知曉率;分析觀察組實施前、實施第7天及實施第14天MEWS值與護理分級的相關(guān)性。結(jié)果:觀察組與對照組意外事件發(fā)生率(3.92%vs.18.00%)、入住ICU率(0.00%vs.5.00%)、醫(yī)患滿意率(99.02%、97.06%vs.93.00%、90.00%)及護士對患者病情"十知道"知曉率(91.18%vs.77.00%)比較差異有統(tǒng)計學(xué)意義(P0.05);觀察組MEWS值與護理級別呈正相關(guān),且實施前、實施第7天及實施第14天相關(guān)系數(shù)rs分別為-0.683、-0.724及-0.895(P0.001),隨著方案的實施,MEWS評分與護理分級的相關(guān)性越高。結(jié)論:基于MEWS的程序化監(jiān)護方案聯(lián)合SBAR模式用于心內(nèi)科,可早期識別"潛在危重病",促進醫(yī)護有效溝通,減少意外事件及入住ICU的發(fā)生,提高醫(yī)患滿意率;且MEWS值可為制定護理級別提供參考依據(jù)。因此,在心內(nèi)科建立病情早期預(yù)警工作流程以及科學(xué)有效、規(guī)范統(tǒng)一的醫(yī)護溝通模板具有較好的應(yīng)用價值。
[Abstract]:Objective: to explore the programmed monitoring scheme for early identification of potential critical illness of patients in cardiology department, and to establish the work flow of early warning of illness and a scientific, effective and standardized medical and nursing communication template. Methods: from October 2014 to February 2016, 210 patients admitted to the Department of Cardiology in our hospital were randomly divided into two groups. The observation group was treated with the combined status, background, evaluation and suggestion (situation-background-assessment-recommendation,SBAR) communication mode of programmed monitoring scheme based on improved early warning score (modified early waring score,MEWS). The control group adopted the traditional monitoring and reporting scheme, observed for 14 days, compared the incidence of accidents, the rate of admission to ICU, the satisfaction rate of doctors and patients, and the awareness rate of nurses to the patient's condition, and analyzed the correlation between mes value and nursing grade on the 7th day and 14th day before the implementation of the observation group. Results: there were significant differences in the incidence of accident between the observation group and the control group (3.92% vs.18.00%), ICU rate (0.00% vs. 5.00%), doctor-patient satisfaction rate (99.02%, 9706% vs.93.00%, 90.00%) and nurses' awareness rate of "ten knowledge" (41.18% vs. 77.00%) (P 0.05). There was a positive correlation between mes value and nursing grade in the observation group, and the correlation coefficients rs on the 7th day and the 14th day were-0.683, 鈮，

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