|本期目录/Table of Contents|

[1]李甜甜,李 晨,寿松涛.改良快速急诊预检分诊系统的临床应用[J].天津医科大学学报,2019,25(06):581-584.
 LI Tian-tian,LI Chen,SHOU Song-tao.Clinical application of improved rapid emergency triage and treatment system[J].Journal of Tianjin Medical University,2019,25(06):581-584.
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改良快速急诊预检分诊系统的临床应用(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
25
期数:
2019年06期
页码:
581-584
栏目:
临床医学
出版日期:
2019-11-20

文章信息/Info

Title:
Clinical application of improved rapid emergency triage and treatment system
文章编号:
1006-8147(2019)06-0581-04
作者:
李甜甜李 晨寿松涛
(天津医科大学总医院急诊科,天津 300052)
Author(s):
LI Tian-tian LI Chen SHOU Song-tao
(Department of Emergency Medicine, General Hospital, Tianjin Medical University, Tianjin 300052, China)
关键词:
急诊预检分诊可靠性灵敏度特异度
Keywords:
emergency triage reliability sensitivity specificity
分类号:
R459.7
DOI:
-
文献标志码:
A
摘要:
目的:探讨改良快速急诊预检分诊系统(RETTS)在急诊预检分诊中的应用效果,以提高急诊预检分诊质量,优化分诊流程。方法:选取2018年11月20日-2018年11月26日就诊于天津医科大学总医院急诊科的患者(年龄≥14岁),由经过培训的研究人员和资深的分诊护士分别使用改良RETTS分诊法和我国常规分诊法对同一患者同时进行预检分诊,根据患者诊疗过程判断实际病情分级。采用SPSS 20.0统计软件进行统计分析,比较两种分诊方法识别危重症患者的可靠性,并应用配对资料?字2检验和一致性检验比较两种分诊方法的准确性和一致性。结果: (1)纳入研究的患者1 405例,平均年龄(49.7±19.2)岁,男性598(42.60%)例,女性807(57.40%)例;(2)改良RETTS法和常规分诊法的准确率分别为77.16%(1 084/1 405)和82.71%(1 162/1 405),分诊过度率分别为19.07%(268/1 405)和1.92%(27/1 405),分诊不足率分别为3.77%(53/1 405)和15.37%(216/1 405),差异有显著统计学意义(t=325.34,P<0.001);(3)改良RETTS法和常规分诊法识别危重症患者的灵敏度分别为65.49%和25.66%,特异度分别为88.39%和99.07%;(4)两种分诊方法结果的一致性差异有统计学意义且一致性较弱(κ=0.069,P<0.001)。结论:改良RETTS分诊方法较低的分诊不足比例和识别危重症患者较高的敏感度可降低患者潜在风险,具有良好的可靠性,有益于保障患者安全。
Abstract:
Objective: To explore the effect of improved rapid emergency triage and treatment system(RETTS) in the emergency pre-examination and triage,so as to improve the quality of emergency triage and optimize the triage process. Methods: Patients(age≥14) in the emergency department of Tianjin medical university general hospital from the 20th to the 26th of november 2018 were triaged by trained researchers and senior triage nurses respectively using improved RETTS and the frequently-used traditional triage method in China.The actual condition grade of the patient was judged according to the patient’s treatment process. SPSS 20.0 statistical software was used for statistical analysis to compare the reliability of the two triage methods in identifying critically ill patients, and the accuracy and consistency of the two triage methods were compared using paired data ?字2 test and consistency test. Results: (1) 1 405 patients were included in the study, with an average age of (49.7±19.2) years, 598(42.60%) males and 807(57.40%) females. (2) The accuracies of the improved RETTS and the traditional triage method were 77.16%(1 084/1 405) and 82.71% (1 162/1 405), the over-triage rates were 19.07%(268/1 405) and 1.92% (27/1 405), and the under-triage rates were 3.77% (53/1 405) and 15.37% (216/1 405), with statistically significant differences (t=325.34, P<0.001). (3) The sensitivity and specificity of improved RETTS and traditional triage method in identifying critically ill patients was 65.49% and 25.66% respectively, and 88.39% and 99.07% respectively. (4) The consistency of results of the two triage methods was statistically significant differences(κ=0.069, P <0.001). Conclusion: The improved RETTS triage method has lower proportion of under-triage and higher sensitivity to identify critical patients, which can reduce the hidden risk of patients and has a good reliability and is beneficial to ensure the safety of patients.

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备注/Memo

备注/Memo:
基金项目 国家临床重点专科建设项目(2013)
作者简介 李甜甜(1992-),女,硕士在读,研究方向:急诊预检分诊;通信作者:寿松涛,E-mail:stshou66@sina.com。
更新日期/Last Update: 2020-01-20