目的 评价并总结体外膜肺氧合支持下患者院际转运安全管理的相关证据,为临床实践提供依据。方法系统检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南协作网、美国卫生保健质量与研究机构网站...目的 评价并总结体外膜肺氧合支持下患者院际转运安全管理的相关证据,为临床实践提供依据。方法系统检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南协作网、美国卫生保健质量与研究机构网站、加拿大医学会临床实践指南库、Cochrane Library、医脉通指南网、体外生命支持组织网站、PubMed、Web of Science、CINAHL、Embase、中国知网、维普数据库、万方数据库中关于体外膜肺氧合支持下患者院际转运管理的相关证据,包括临床决策、指南、证据总结、最佳实践、专家共识、推荐意见、系统评价及Meta分析,检索时限为建库至2022年9月。由4名研究者独立进行文献质量评价和资料提取。结果 共纳入13篇文献,其中指南2篇、专家共识8篇、系统评价3篇。从团队组成、响应和准备、转运实践、管理和质量控制4个方面总结了37条证据。结论 该研究总结了体外膜肺氧合支持下患者院际转运安全管理的最佳证据,为临床开展院际转运实践提供依据。展开更多
Background:With the unequal distribution of medical resources in developing countries,critially ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources.Although a large ...Background:With the unequal distribution of medical resources in developing countries,critially ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources.Although a large number of critically ill children are transferred each day in China,the standard process of inter-hospital transport is not formulated.Methods:We retrospectively analyzed the data collected during transport.A total number of 9231 patients(≤14 years)who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1,2009 to June 30,2012 were included in the study.Results:Nearly half of the critically ill children were neonates(48.72%)and two thirds of the children were suffering from respiratory,neurological and cardiac diseases.Multivariate adjusted odds ratios(OR)and 95%confidence intervals(CI)were calculated using unconditional logistic regression.Mobilization time in non-working hours was longer than the working hours(OR=1.186,95%CI=1.059-1.329).Our study showed that mobilization time for neonates was shorter than that for older children(OR=0.801,95%CI=0.692-0.928).The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km(OR=0.427,95%CI=0.350-0.521).Referred patients in summer needed a significantly shorter mobilization time than in winter(OR=0.705,95%CI=0.616-0.806).Conclusion:Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.展开更多
文摘目的 评价并总结体外膜肺氧合支持下患者院际转运安全管理的相关证据,为临床实践提供依据。方法系统检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南协作网、美国卫生保健质量与研究机构网站、加拿大医学会临床实践指南库、Cochrane Library、医脉通指南网、体外生命支持组织网站、PubMed、Web of Science、CINAHL、Embase、中国知网、维普数据库、万方数据库中关于体外膜肺氧合支持下患者院际转运管理的相关证据,包括临床决策、指南、证据总结、最佳实践、专家共识、推荐意见、系统评价及Meta分析,检索时限为建库至2022年9月。由4名研究者独立进行文献质量评价和资料提取。结果 共纳入13篇文献,其中指南2篇、专家共识8篇、系统评价3篇。从团队组成、响应和准备、转运实践、管理和质量控制4个方面总结了37条证据。结论 该研究总结了体外膜肺氧合支持下患者院际转运安全管理的最佳证据,为临床开展院际转运实践提供依据。
基金supported by a grant from the Ministry of Science and Technology in China(2012BAI04B02).
文摘Background:With the unequal distribution of medical resources in developing countries,critially ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources.Although a large number of critically ill children are transferred each day in China,the standard process of inter-hospital transport is not formulated.Methods:We retrospectively analyzed the data collected during transport.A total number of 9231 patients(≤14 years)who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1,2009 to June 30,2012 were included in the study.Results:Nearly half of the critically ill children were neonates(48.72%)and two thirds of the children were suffering from respiratory,neurological and cardiac diseases.Multivariate adjusted odds ratios(OR)and 95%confidence intervals(CI)were calculated using unconditional logistic regression.Mobilization time in non-working hours was longer than the working hours(OR=1.186,95%CI=1.059-1.329).Our study showed that mobilization time for neonates was shorter than that for older children(OR=0.801,95%CI=0.692-0.928).The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km(OR=0.427,95%CI=0.350-0.521).Referred patients in summer needed a significantly shorter mobilization time than in winter(OR=0.705,95%CI=0.616-0.806).Conclusion:Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.
