目的 对危重患者院内转运不良事件影响因素的相关研究进行范围综述,以期为未来相关研究及应用提供参考。方法 遵循澳大利亚乔安娜布里格斯研究所发布的范围综述指南为方法学框架,检索包括中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library、CINAHL,检索时限为建库至2024年11月30日,对文献进行纳入和汇总。结果 共纳入27篇文献。危重患者院内转运不良事件影响因素包括患者因素、治疗因素、转运系统资源配置因素、转运过程因素等。结论 本研究揭示了危重患者院内转运不良事件的多因素影响机制,强调了在转运过程中对患者进行细致评估和准备的重要性。目前我国关于危重患者院内转运不良事件影响因素的多中心、前瞻性的大样本研究较少,建议未来研究开展多中心协作研究,建立标准化的数据采集系统,为制定科学规范的危重患者院内转运指南提供更可靠的循证依据。
Abstract
Objective To conduct a scoping review of studies on the factors influencing the adverse events of intra-hospital transfers of critically ill patients, and to provide reference for future related studies and applications. Methods Following the scoping guidelines published by the Joanna Briggs Institute in Australia as the methodological framework, we retrieved literature from CNKI, WanFang Database, VIP Database, China Biomedical Literature Service System, PubMed, Web of Science, Embase, Cochrane Library, and CINAHL, with a retrieval time spanning from the inception to 30 November 2024. Literature were analyzed and summarized. Results Twenty-seven studies were included. Factors influencing adverse events of intra-hospital transfer of critically ill patients included patient-related factors, therapeutic factors, transfer system resource allocation, and transfer process. Conclusion This study reveals the multifactorial mechanisms influencing the adverse events of intra-hospital transfers of critically ill patients, highlighting the importance of thorough patient assessment and preparation prior to the transfer. Currently, there are fewer multicenter, prospective, large-sample studies on the factors influencing the adverse events of intra-hospital transport of critically ill patients in China, and we recommend future multicenter collaborative research with standardized data collection systems to provide more robust evidence for developing scientific, standardized guidelines for intra-hospital transfer of critical patients.
关键词
危重患者 /
院内转运 /
不良事件 /
影响因素 /
范围综述
Key words
critically ill patient /
in-hospital transfer /
adverse event /
influencing factor /
scoping review
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 孙志辉,魏崴,魏耀耀,等. 标准化分级转运方案在ICU危重症患者院内转运安全管理中的应用及效果[J]. 中国标准化,2023(8):275-278. DOI:10.3969/j.issn.1002-5944.2023.08.056.
[2] Murata M, Nakagawa N, Kawasaki T, et al.Adverse events during intrahospital transport of critically ill patients: a systematic review and Meta-analysis[J]. Am J Emerg Med,2022(52):13-19. DOI:10.1016/j.ajem.2021.11.021.
[3] 刘晁含,付沫,丁娟,等. 危重患者院内转运的最佳证据总结[J].护理学报,2020,27(15):33-38.DOI:10.16460/j.issn1008-9969.2020.15.033.
[4] 宋玲,马俊杰,王硕,等. 急诊危重症病人院内转运不良事件发生危险因素的Meta分析[J].全科护理,2023,21(28):3906-3910. DOI:10.12104/j. issn. 1674-4748. 2023.28. 004.
[5] 刘茹,赵文婷,杜娟,等. 危重患者院内转运不良事件危险因素的Meta分析[J]. 护理学杂志,2022,37(17):31-35. DOI:10.3870/j.issn.1001-4152.2022.17.031.
[6] 周雯,甘秀妮,黄苗,等. 范围综述方法在中文护理期刊发文现状的可视化分析[J]. 护士进修杂志,2024,39(13):1449-1453. DOI:10.16821/j.cnki.hsjx.2024.13.018.
[7] Lockwood C, Dos Santos KB, Pap R.Practical guidance for knowledge synthesis: scoping review methods[J]. Asian Nurs Res (Korean Soc Nurs Sci), 2019,13(5):287-294. DOI:10.1016/j.anr.2019.11.002.
[8] Zirpe KG, Tiwari AM, Kulkarni AP, et al.Adverse events during intrahospital transport of critically ill patients: a multicenter, prospective, observational study (I-TOUCH Study)[J]. Indian J Crit Care Med, 2023, 27(9):635-641. DOI:10.5005/jp-journals-10071-24530.
[9] Nonami S, Kawakami D, Ito J, et al.Incidence of adverse events associated with the in-hospital transport of critically ill patients[J]. Crit Care Explor, 2022,4(3):e0657. DOI:10.1097/CCE.0000000000000657.
[10] Catalán-Ibars RM, Martín-Delgado MC, Puigoriol-Juvanteny E, et al.Incidents related to critical patient safety during in-hospital transfer[J]. Med Intensiva (Engl Ed), 2022,46(1):14-22. DOI:10.1016/j.medine.2021.11.002.
[11] Neal-Williams T, Walker K, Lines T, et al.Risk events during intrahospital transport of patients from the emergency department: a prospective observational study[J]. Emerg Med J, 2021, 38(10):776-779.DOI:10.1136/emermed-2021-211409.
[12] Mohd Ismail MR, Baharuddin KA, Zainal Abidin ZE, et al.Study on the incidence of adverse events during intra-hospital transfer of critical care patients from emergency department[J]. Med J Malaysia, 2020,75(4):325-330.
[13] Seilbea LY, De Vasconcellos K.Adverse events during the intrahospital transfer of critically ill perioperative patients in a South African tertiary hospital[J]. South Afr J Anaesth, 2020, 26(3):131-138.
[14] Veiga VC, Postalli NF, Alvarisa TK, et al.Adverse events during intrahospital transport of critically ill patients in a large hospital[J]. Rev Bras Ter Intensiva, 2019,31(1):15-20. DOI: 10.5935/0103-507X.20190003.
[15] Bergman LM, Pettersson ME, Chaboyer WP, et al.Safety hazards during intrahospital transport: a prospective observational study[J]. Crit Care Med, 2017, 45(10):e1043-e1049.DOI:10.1097/CCM.0000000000002653.
[16] Hajjej Z, Gharsallah H, Boussaidi I, et al.Risque d'incidents lors des transports intra hospitaliers des patients de réanimation risk of mishaps during intrahospital transport of critically ill patients[J]. La Tunisie Medicale, 2015, 93(11):708-713.
[17] Parmentier-Decrucq E, Poissy J, Favory R, et al.Adverse events during intrahospital transport of critically ill patients: incidence and risk factors[J]. Ann Intensive Care, 2013,3(1):10. DOI:10.1186/2110-5820-3-10.
[18] 陶珍珍,王志伟,祁进芳,等. 急危重症患者院内转运不良事件风险预测模型的构建[J]. 护理管理杂志,2024,24(7):614-618,624. DOI:10.3969/j.issn.1671-315x.2024.07.012.
[19] 姚小云,李玉肖,陈亚玲,等. 急诊科危重症患者院内转运不良事件的风险预测模型构建[J]. 军事护理,2024,41(2):51-55. DOI:10.3969/j.issn.2097-1826.2024.02.012.
[20] 袁乃珍,沈春华. 急诊危重患者院内转运过程中临床恶化的危险因素分析及护理[J]. 实用临床医药杂志,2024,28(21):137-141,148. DOI:10.7619/jcmp.20242570.
[21] 祁琪,张文玲,李玉芳. 急诊患者院内转运期间病情恶化的危险因素分析[J]. 中国医药,2023,18(2):265-269. DOI:10.3760/j.issn.1673-4777.2023.02.024.
[22] 涂先志.急诊患者实施院内转运的风险及其影响因素[J/OL].中文科技期刊数据库(全文版)医药卫生,2023(6):8-11[2024-12-15]. https://www.cqvip.com/doc/journal/3198484664.
[23] 林志华. 急诊危重患者院内转运不良事件发生情况及危险因素分析[J].医疗装备,2022,35(1):179-181. DOI:1002-2376(2022)01-0179-03.
[24] 刘冬连,钟芬梅,湛薇.急诊危重患者院内转运过程不良事件发生情况及其相关因素分析[J].中国医学创新,2022,19(9):122-126.DOI:10.3969/j.issn.1674-4985.2022.09.031.
[25] An Y, Tian ZR, Li F, et al.Establishment of a simplified score for predicting risk during intrahospital transport of critical patients: a prospective cohort study[J]. J Clin Nurs, 2023,32(7-8):1125-1134. DOI:10.1111/jocn.16337.
[26] 赵春华,张小伟,任玉芝.危重症患者院内安全转运发生血氧饱和度降低的影响因素分析[J].齐鲁护理杂志,2021,27(15):140-142.DOI:10.3969/j.issn.1006-7256.2021.15.051.
[27] 金婉婉,李博,梁敏,等. 急诊患者实施院内转运的风险及其影响因素[J].国际护理学杂志,2020,39(12):2136-2140. DOI:10.3760/cma.j.cn221370-20190124-00664.
[28] 刘兰. 急诊危重患者院内转运不良事件发生状况及其影响因素[J].河南医学研究,2020,29(31):5815-5817. DOI: 10.3969/j.issn.1004-437X.2020.31.016.
[29] 李旭蓉,杨强,程林英,等.急诊危重症患者院内安全转运的相关危险因素分析[J].中国卫生统计,2019,36(6):928-929.
[30] 卢玲,何喜军.院内转运护理用于急诊危重症患者危险因素[J].中国卫生标准管理,2019,10(22):143-146. DOI:10.3969/j.issn.1674-9316.2019.22.059.
[31] 马莉,王志稳,葛宝兰,等.急诊科危重病人院内转运过程中不良事件及风险因素分析[J].护理研究, 2019, 33(21):3676-3680.DOI:10.12102/j. issn.1009-6493.2019.21.008.
[32] 张佳佳,梁世景,罗诗婷.ICU病人院内转运检查的风险与影响因素[J].护理研究,2019,33(24):4343-4346.DOI:10.12102/j. issn.1009-6493. 2019. 24. 035.
[33] 岳磊于,石贞仙,吴慧,等.ICU患者在院内转运时血氧饱和度降低的影响因素分析[J].中华护理杂志, 2017,52(12):1478-1482. DOI:10.3761/j.issn.0254-1769.2017.12.014.
[34] Jia L, Wang H, Gao Y, et al.High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: a prospective, multicenter study in China[J]. Crit Care,2016(20):12.DOI:10.1186/s13054-016-1183-y.
[35] 葛均波,王辰. 内科学[M].10版. 北京:人民卫生出版社,2024:10-17.
基金
湖北省科技创新专项立项项目（2021CFB601）; 荆州市科技局项目（2024HD48）
PDF(992 KB)
