主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (9): 1294-1299.doi: 10.3969/j.issn.1672-1756.2025.09.003

• 特别策划·重症患者安全 • 上一篇    下一篇

ICU有创机械通气患者院内转运管理情况调查

邓娟 孙桉琪 李靖锟 熊杰 柯键 邹灯秀 蒋梦瑶 王颖 胡雁 严丽   

  1. 华中科技大学同济医学院附属同济医院护理部,重症医学科,430030 武汉市(邓娟,熊杰,柯键,邹灯秀,蒋梦瑶,王颖,严丽);华中科技大学同济医学院护理学院(孙桉琪,李靖锟);复旦大学护理学院,复旦大学循证护理中心(胡雁)
  • 出版日期:2025-09-15 发布日期:2025-09-15
  • 通讯作者: 邹灯秀,硕士,副主任护师,护士长,E-mail:177979565@qq.com
  • 作者简介:邓娟,硕士,副主任护师,护士长
  • 基金资助:
    国家自然科学基金面上项目(72274067);华中科技大学同济医学院附属同济医院科研基金护理专项项目(2022D04,2022D25);复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202502)

Investigation on intra-hospital transport management of mechanically ventilated patients in ICU

DENG Juan, SUN Anqi, LI Jingkun, XIONG Jie, KE Jian, ZOU Dengxiu, JIANG Mengyao, WANG Ying, HU Yan, YAN Li   

  1. Nursing Department, ICU, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
  • Online:2025-09-15 Published:2025-09-15
  • Contact: E-mail:177979565@qq.com

摘要: 目的:调查ICU有创机械通气患者院内转运管理情况,为提升转运安全质量提供依据。方法:基于患者安全系统工程模型设计调查问卷,于2025年2月—3月,采用便利抽样法,选取我国不同级别医院的975名ICU护士及80名护理管理者进行调查。结果:有创机械通气患者院内转运率的中位数为43.45%(18.89%,66.36%)。在科室转运组织管理方面,建立并应用有创机械通气患者院内转运风险评分系统(27.50%)、建立有创机械通气患者院内转运质量评价标准(46.25%)等条目占比较低。转运实践中,执行率排名后3位的条目为转运前暂停胃内营养30 min并检查胃排空情况(61.85%),评估气管插管或气管切开套管气囊充分程度及气囊压力是否适宜(74.26%),转运中密切关注镇静或肌松药导致的呼吸抑制情况(73.64%)。结论:ICU有创机械通气患者院内转运管理情况总体较好,但需要提升对患者系统性评估和全程监测意识。高负荷转运任务与人力配置不匹配,应加强人力资源配置与能力培养。同时,应落实转运组织管理和流程优化,推动转运安全、高效执行。

关键词: 机械通气;重症监护室;院内转运;患者安全系统工程模型;问卷调查

Abstract: Objective: To examine the current management status of intra-hospital transport of mechanically ventilated patients in ICU, and to provide evidence for improving transport safety. Methods: Based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, a questionnaire was developed and used in a cross-sectional survey of 975 ICU nurses and 80 nursing managers from hospitals of different levels using convenience sampling method between February and March 2025. Results: The median implementation rate for intra-hospital transport was 43.45% (18.89%, 66.36%). In terms of departmental transportation organization management, the items with relatively low feedback included: establishing and applying an invasive mechanical ventilation in-hospital transportation risk scoring system (27.50%), establishing an invasive mechanical ventilation in-hospital transportation quality evaluation standard (46.25%), etc. Practices with lower compliance included: pausing enteral nutrition 30 minutes and checking gastric emptying (61.85%), checking cuff inflation and pressure before transport (74.26%), and monitoring respiratory depression during transport for patients on sedatives or muscle relaxants (73.64%). Conclusion: ICU nurses generally perform well in transporting mechanically ventilated patients. However, there is a need to enhance the awareness of systematic patient assessment and whole-process monitoring. The mismatch between high-load transport tasks and human resource allocation should be addressed by strengthening human resource allocation and capacity building. Meanwhile, organizational management and process optimization of transport should be implemented to promote safe and efficient execution of transport.

Key words: mechanical ventilation; ICU; intra-hospital transport; Systems Engineering Initiative for Patient Safety; questionnaire survey

中图分类号:  R47;R197