摘要目的 探讨抢救视频逻辑切片与互动分析在多发伤急救护理质量持续改进中的作用.方法 成立抢救视频互动分析管理小组,2015年5月至2016年4月,于每周三上午8:00-11:00选取武汉大学中南医院急救中心急诊危重病历管理软件中登记的多发伤患者资料,通过收集整理抢救室内安装的视频监控系统中的视频,进行典型案例抢救视频逻辑切片,根据多发伤的诊疗救治特点,制定多发伤急诊救治护理质量评价指标,应用失效模式分析法和根本原因分析法对视频数据进行互动分析,针对分析结果进行多发伤急诊救治护理质量的控制与改进,比较实施抢救视频逻辑切片与互动分析管理前后的多发伤急救护理质量指标检查结果、患者满意度及护理缺陷发生率.结果实施前多发伤患者急诊救治时间、患者抢救成功率、患者转运缺陷率、抢救单元物品缺失率分别为(87.1±7.4)min、90.77%(59/65)、30.77%(20/65)、12.31%(8/65),实施后分别为(57.5±5.2)min、100.00%(68/68)、10.29%(7/68)、2.94%(2/68),实施前后比较差异有统计学意义(t=26.84,χ2=2.15、2.72、1.72,均P<0.05).实施抢救视频逻辑切片与互动分析后,患者家属各项评价满意度提高,差异有统计学意义(χ2=15.45~23.21,P<0.05).结论 抢救视频逻辑切片与互动分析在护理质量持续改进中的应用有效的减少了患者的抢救时间,提高了患者的抢救成功率,降低了患者转运缺陷率和单元物品缺失率,有效的控制了环节质量,提高了管理效能,实现了抢救时常态8作下的规范化、标准化管理.

abstractsObjective To explore the role of rescue video logical slice and interactive analysis in the continuous improvement of quality of emergency care of multiple injury. Methods To establish a management team for the rescue video interactive analysis. From May, 2015 to April, 2016, every Wednesday from 8:00-11:00 am, the data of multi-injury patients registered in our management software of critical emergency cases were selected. A typical case study of the rescue video logical slices were processed through sorting the video cases in the video surveillance system installed in the emergency room. According to the characteristics of diagnosis and treatment of multiple injury, the evaluation indexes of nursing quality in emergency treatment of multiple injury were formulated and video data was analyzed interactively by using the failure mode analysis and root cause analysis. Based on the above analyzed results, the quality of emergency care of Multiple Injury was controlled and improved. Before and after performing the rescue video logic slices and interactive analysis management, the examined results of multiple injury first-aid nursing quality index, as well as the rate of patients satisfaction and nursing defects were compared. Results Before the implementation of the above method, the time of emergency treatment for multiple injury, the rate of patients with successful rescue, the rate of patient transport defect and the rate of missing items in the rescue unit were respectively as follows:(87.1±7.4)min, 90.77%(59/65), 30.77%(20/65), 12.31%(8/65),whereas after the implementation, the relevant data were (57.5 ± 5.2) min, 100.00%(68/68), 10.29%(7/68), 2.94%(2/68). The comparative difference before and after the implementation was statistically significant (t=26.84, χ2=2.15, 2.72, 1.72, all P < 0.05). Besides, the satisfaction with the various evaluations of patients′ family members was increased and the differences were statistically significant (χ2=15.45-23.21, P<0.05). Conclusions The introduction of rescue video slices and interactive analysis can effectively reduce the patient′s rescue time, improve the success rate of patients rescues, decrease the rate of patient transport defect and missing items in the rescue unit, effectively control the quality of links, improve the management efficiency, and thus realize the standardized management under normal working condition.