The impact of rapid response nursing team model on the quality of hierarchical nursing management and rescue efficiency in emergency departments of tertiary hospitals
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摘要:
目的 分析快速反应护理团队模式在三甲医院急诊科护理管理中的应用效果，为三甲医院急诊科推广快速反应护理团队模式提供科学依据。 方法 选择2021年1月—2024年6月在温州医科大学附属第二医院就诊的120例急诊创伤患者为研究对象。利用随机数字表法将研究对象随机分为2组（每组各60例），对照组患者实施常规的分层护理管理模式, 观察组患者在接受常规急诊分层护理管理的基础上开展快速反应团队模式干预。比较2组患者的护理时效、抢救成功率、患者家属满意度、不良事件发生率。 结果 干预后，观察组患者静脉通路建立时间、脊柱板使用时间、血常规送检时间、止血药使用时间、首次CT检查时间、抢救室滞留时间均少于对照组（P < 0.05）；观察组抢救成功率为98.33%（59/60），显著高于对照组的86.67%（52/60），不良事件发生率[3.33%（2/60）]显著低于对照组[13.33%（8/60）]，差异有统计学意义（χ2=4.324、3.927；P=0.038、0.048）；观察组患者家属护理满意度显著优于对照组（P < 0.05）。 结论 快速反应护理团队模式能够有效提升急诊科护理管理的规范性和时效性，缩短急救时间，提高抢救成功率，降低不良事件发生率，这为急诊科的护理管理提供了有效的实践指导。 Abstract:Objective Analysis of the application effect of the rapid response team (RRT) model in the hierarchical nursing management of the emergency department of tertiary hospitals, and to provide a scientific basis for the promotion of the RRT model in the emergency department of tertiary hospitals. Methods A total of 120 emergency trauma patients who visited the Second Affiliated Hospital of Wenzhou Medical University from January 2021 to June 2024 were selected as the research subjects. Using a random number table, the research subjects were randomly divided into two groups (60 cases each). The control group patients received the conventional stratified nursing management model, while the observation group patients received the rapid response team mode intervention in addition to the conventional emergency stratified nursing management. Nursing efficiency, rescue success rate, satisfaction of patients' families, and incidence of adverse events were compared between the two groups. Results After the intervention, the time for establishing intravenous access, the time for using the spinal board, the time for sending blood routine tests, the time for using hemostatic drugs, the time for the first CT examination, and the time spent in the rescue room in the observation group were all shorter than those in the control group (P < 0.05). The rescue success rate in the observation group was 98.33% (59/60), significantly higher than that in the control group 86.67%, 52/60), and the incidence of adverse events [3.33% (2/60)] was significantly lower than that in the control group [13.33% (8/60)], with statistically significant differences (P < 0.05). The scores of nursing satisfaction of patients' families in the observation group were significantly higher than those in the control group (χ2=4.324, 3.927; P=0.038, 0.048). Conclusion The RRT model significantly improves the standardization and timeliness of emergency department nursing management, shortens emergency response time, increases the rescue success rate, and reduces the incidence of adverse events, providing effective practical guidance for nursing management in emergency departments of tertiary hospitals. -
Key words:
- Rapid response nursing team /
- Emergency treatment /
- Layered care /
- Rescue efficiency
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表 1 2组急诊创伤患者一般资料比较
Table 1. Comparison of general information between the two groups of emergency trauma patients
组别 例数 性别[例(%)] 年龄(x±s，岁) 受伤类型[例(%)] 受伤部位[例(%)] 男性 女性 交通 摔伤 锐器 其他 头颈 胸部 腹部 四肢及脊柱 对照组 60 35(58.33) 25(41.67) 48.07±5.53 28(46.67) 17(28.33) 9(15.00) 6(10.00) 23(38.33) 9(15.00) 7(11.67) 21(35.00) 观察组 60 34(56.67) 26(43.33) 47.92±5.02 26(43.33) 16(26.67) 11(18.33) 7(11.67) 25(41.67) 8(13.33) 5(8.33) 22(36.67) 统计量 0.034a 0.156b 0.381a 0.499a P值 0.853 0.877 0.944 0.919 注：a为χ2值，b为t值。 
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表 2 2组急诊创伤患者护理时效相关指标比较(x±s, min)
Table 2. Comparison of nursing timeliness-related indicators between the two groups of emergency trauma patients (x±s, min)
组别 例数 静脉通路建立时间 脊柱板使用时间 血常规送检时间 止血药使用时间 首次CT检查时间 抢救室滞留时间 观察组 60 4.23±0.87 5.82±1.54 8.62±1.22 30.02±5.52 24.37±3.88 190.75±34.70 对照组 60 7.43±1.45 10.50±3.25 12.51±2.20 43.96±5.77 28.85±4.29 283.62±43.11 t值 14.659 10.080 11.978 13.522 6.000 13.000 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001
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表 3 2组急诊创伤患者抢救成功率和不良事件发生率比较[例(%)]
Table 3. Comparison of rescue success rate and incidence of adverse events between the two groups of emergency trauma patients [cases (%)]
组别 例数 抢救成功 致残 病死 不良事件 发生 未发生 观察组 60 59(98.33) 0 1(1.67) 2(3.33) 58(96.67) 对照组 60 52(86.67) 2(3.33) 5(8.33) 8(13.33) 52(86.67) χ2值 4.324 3.927 P值 0.038 0.048
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表 4 2组急诊创伤患者家属护理满意度比较(x±s, 分)
Table 4. Comparison of satisfaction scores of family members between the two groups of emergency trauma patients (x±s, points)
组别 例数 操作速度 护理流畅性 处置方法 完成效果 总分 观察组 60 22.62±1.41 22.34±3.05 21.45±3.52 22.61±3.52 88.53±6.53 对照组 60 18.12±2.25 19.02±2.36 18.93±3.38 19.43±2.93 79.01±5.94 t值 13.127 6.669 4.000 5.378 8.354 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001
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[1] 张金燕, 杨丽萍, 彭庆荣. 基于多学科协作团队的急救护理路径在创伤性休克患者中的应用[J]. 中华现代护理杂志, 202l, 27(7): 948-951.Zhang J Y, Yang L P, Peng Q R. Application of emergency nursing pathway based on multidisciplinary team in patients with traumatic shock[J]. Chinese Journal of Mordern Nursing, 2021, 27(7): 948-951. [2] 郭爱清, 姜晓真, 郑卫霞, 等. 分层级责任制整体护理在急诊患者中的应用[J]. 齐鲁护理杂志, 2022, 28(12): 110-113.Guo A Q, Jiang X Z, Zheng W X, et al. Application of hierarchical responsibility holistic nursing in emergency patients[J]. Journal of Qilu Nursing, 2022, 28(12): 110-113. [3] 钱琳玲, 周春凤, 陈云萍, 等. 快速反应团队护理管理模式在急诊严重创伤患者中的应用[J]. 中国乡村医药, 2023, 30(24): 68-72.Qian L L, Zhou C F, Chen Y P, et al. Application of rapid response team nursing management model in emergency patients with severe trauma[J]. Chinese Journal of Rural Medicine and Pharmacy, 2023, 30(24): 68-72. [4] 白亚蓓, 赵印, 胡冬冬, 等. 基于快速反应团队模式的分级护理在颅脑损伤患者中的应用[J]. 齐鲁护理杂志, 2024, 30(1): 108-111.Bai Y B, Zhao Y, Hu D D, et al. Application of graded nursing based on rapid response team model in patients with craniocerebral injury[J]. Journal of Qilu Nursing, 2024, 30(1): 108-111. [5] 中华医学会. 临床诊疗指南(创伤学分册)[M]. 北京: 人民卫生出版社, 2007: 35-60.Chinese Medical Association. Clinical Guidelines (Trauma Volume)[M]. Beijing: People's Medical Publishing House, 2007: 35-60. [6] 钱萍, 张秋霞, 泮燕红, 等. 神经外科快速反应小组启动延迟的影响因素及改进策略[J]. 中华危急重症护理杂志, 2023, 4(3): 258-262.Qian P, Zhang Q X, Pan Y H, et al. Influencing factors and countermeasures of delayed rapid response team activation in Neurosurgery Department[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(3): 258-262. [7] 李明军, 方晓霞, 来艳丽, 等. 以时机理论为基础的快速反应团队模式在急性缺血性脑卒中患者中的应用[J]. 国际护理学杂志, 2025, 44(2): 229-232.Li M J, Fang X X, Lai Y L, et al. Application of timing theory-based rapid response team model in patients with acute ischemic stroke[J]. International Journal of Nursing, 2025, 44(2): 229-232. [8] 刘安辉, 凌芳, 胡芳, 等. 优质管理和分层级管理模式在急诊科护士管理中的应用效果比较[J]. 中西医结合护理(中英文), 2023, 9(3): 160-162.Liu A H, Ling F, Hu F, et al. Comparative study on the application effects of quality management and hierarchical management model in emergency department nurse management[J]. Journal of Clinical Nursing in Practice(Chinese and English), 2023, 9(3): 160-162. [9] 康霞. 急诊快速反应团队应用于严重创伤患者的护理时效研究[J]. 护理管理杂志, 2020, 20(5): 364-368.Kang X. A study on the nursing time efficiency of emergency rapid response team used in severe injuries patients[J]. Journal of Nursing Administration, 2020, 20(5): 364-368. [10] 何佳涛, 沈小玲. 抢救案例分享结合应急预演对急诊预检分诊质量及护士工作能力的影响[J]. 中华全科医学, 2021, 19(1): 154-160. doi: 10.16766/j.cnki.issn.1674-4152.001754He J T, Shen X L. Effect of rescue case sharing combined with emergency preview on the quality of emergency pre-examination and triage and the working ability of nurses[J]. Chinese Journal of General Practice, 2021, 19(1): 154-160. doi: 10.16766/j.cnki.issn.1674-4152.001754 [11] 水玲玲, 王珂佳, 高慧芳. 快速护理团队模式联合护理行为感知模式对急危重症剖宫产术产妇的影响观察[J]. 临床研究, 2025, 33(1): 164-167.Shui L L, Wang K J, Gao H F. Impact of rapid response nursing team model combined with perceived nursing behavior model on parturients undergoing emergency cesarean section[J]. Clinical Research, 2025, 33(1): 164-167. [12] 黄雅丽, 蔡淑红, 王谢磊, 等. 转运标准化流程管理在儿科体外膜肺氧合快速反应团队中的应用[J]. 中华急危重症护理杂志, 2024, 5(4): 305-311.Huang Y L, Cai S H, Wang X L, et al. Application of standardized transport process management in pediatric extracorporeal membrane oxygenation rapid response team[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(4): 305-311. [13] 孙莉, 庄长娟, 刘蕊, 等. 紧急医学救援急诊快速响应救护模式的构建[J]. 中国护理管理, 2021, 12(2): 1768-1770.Sun L, Zhuang C J, Liu R, et al. Construction of the rapid response rescue mode in emergency departments[J]. Chinese Nursing Management, 2021, 12(2): 1768-1770. [14] 黄秀钦, 胡锐, 林炎斌. 快速反应团队模式结合损伤控制理论在创伤性休克患者救治中的应用[J]. 中西医结合护理(中英文), 2024, 10(5): 168-170.Huang X Q, Hu R, Lin Y B. Application of rapid response team model combined with damage control theory in the treatment of patients with traumatic shock[J]. Journal of Clinical Nursing in Practice(Chinese and English), 2024, 10(5): 168-170. [15] 贺尼娅, 景峰, 唐敏. 快速反应团队工作模式在急性左心衰竭患者抢救中的应用效果[J]. 中西医结合护理(中英文), 2023, 9(12): 142-144.He N Y, Jing F, Tang M. Application effect of rapid response team working model in rescuing patients with acute left heart failure[J]. Journal of Clinical Nursing in Practice(Chinese and English), 2023, 9(12): 142-144. [16] 彭璟. 急诊快速反应团队模式护理干预在急诊严重创伤患者中的应用效果[J]. 中国医药科学, 2021, 11(7): 162-165.Peng J. Application effect of nursing intervention of emergency rapid response team model in patients with severe trauma in department of emergency[J]. China Medicine and Pharmacy, 2021, 11(7): 162-165.
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