摘要目的：探讨专职化分层护理小组模式在急诊科心血管危重患者抢救中的应用实践。方法改变传统抢救护理方法，由三级护士构成专职化分层护理小组（专职组）为中心的急救模式。比较专职组与传统护理小组（传统组）在急诊心功能Ⅳ级、心绞痛Ⅳ级、急性ST段抬高心肌梗死（ STEMI）患者抢救中静脉通道开放时间、急诊室滞留时间，患者家属及医生对急救护理工作满意度情况。结果专职组静脉通道开放时间及抢救室滞留时间分别为（3．6±1．3），（55．6±25．7） min，较传统组的（4．4±1．3），（62．6±29．3）min明显缩短，两组比较差异有统计学意义（t分别为5．913，2．554；P＜0．05）；专职组患者家属及医生对专职组急救护理工作满意度分别为95．6％，98．9％，均优于传统组的88．7％，91．4％，且差异有统计学意义（χ2分别为4．98，9．43；P＜0．05）。结论专职化分层护理小组对急诊抢救室护理工作有一定促进作用，能有效提高急诊科护士核心能力，确保急救护理服务质量。

abstractsObjective To investigate the application of specific duty hierarchical nursing team in rescuing cardiovascular critical patients .Methods We changed traditional nursing care ( traditional group ) into specific duty hierarchical nursing team ( specific group ) composed of three-rating nurses and compared open venous channel time and ER retention time in rescuing patients with NYHA Ⅳ, Angina grade Ⅳ and ST-segment elevation myocardial infarction ( STEMI).We also surveyed the family members of patients and&nbsp;doctors’ satisfaction with the practice of specific group in nursing .Results The open venous channel time (3.6 ±1.3) min and ER retention time ( 55.6 ±25.7 ) min were significantly reduced in specific group compared to traditional group [respectively (4.4 ±1.3),(62.6 ±29.3)min](t=5.913,2.554,respectively;P<0.05).The patients and doctors’ satisfaction rate with nursing service in specific groups was 95.6% and 98.9%,which were better than those in traditional group (88.7%,91.4%), and the differences were statically significant(χ2 =4.98,9.43,respectively;P<0.05).Conclusions Specific duty hierarchical nursing benefited nursing care of emergency room , enhanced core competencies of nurses and ensured the quality of emergency care.