论著

眼科急诊预检分诊标准体系构建及初步验证

Construction and preliminary verification of the ophthalmic emergency pre-examination and triage standard system

:91-98
 
目的:基于我国国情构建科学、简便且高效的眼科急诊预检分诊标准,为眼科医护人员提供高效的眼科急诊预检分诊工具。方法:基于文献查询法、半结构访谈法、德尔菲法及层次分析法确定眼科急诊预检分诊标准内容。通过提取2023年8月1日-2023年8月10日急诊分诊系统及HIMSS电子病历系统数据,分析初次分诊的级别与接诊医生最终诊断的所属级别符合率,对眼科急诊预检分诊标准体系的应用效果进行初步验证。结果:对18名专家进行2轮专家咨询,有效问卷回收率均为100%,专家权威系数均为0.95,肯德尔和谐系数分别为0.5640.117(均P<0.05)。最终构建的眼科急诊预检分诊标准体系包括3个一级指标、11个二级指标。初步验证显示,该预检分诊标准体系具有92.7%的分诊准确率。结论:本研究构建的眼科急诊预检分诊标准体系结构合理、内容全面,具有科学性及实用性,可为眼科临床急诊预检分诊工作提供准确、有效的分诊工具,有助于提高临床工作效率及预检分诊质量。
Objective: To establish a scientific, simple, and efficient ophthalmic emergency pre-examination triage standard, and provide efficient ophthalmic emergency pre-examination triage tools for ophthalmic staffs, based on national conditions. Methods: With literature search, semi-structured interview, Delphi Method, and Analytic Hierarchy Process, the content of ophthalmic emergency pre-examination and triage standard are confirmed. By extracting data from the emergency triage system and HIMSS electronic medical record system from August 1st, 2023 to August 10th, 2023, the consistency rate between the initial triage level and the final diagnosis level of the attending doctor was analyzed, and the application effect of the ophthalmic emergency pre-examination and triage standard system was preliminarily verified. Results: Two rounds of expert consultation were conducted among 18 experts, all with a 100% effective questionnaire response rate. The expert authority coefficients were 0.95, and the Kendall harmony coefficients were 0.564 and 0.117, respectively (all P<0.05). The final constructed ophthalmic emergency pre-examination triage standard system includes 3 primary indicators and 11 secondary indicators. Through verification, the pre screening triage standard system has a good triage accuracy rate of up to 92.7%. Conclusions: The structure of the ophthalmic emergency pre-examination triage standard system constructed in this study is reasonable, comprehensive, scientific, and practical. It can provide accurate and effective triage tools for ophthalmic clinical emergency pre-examination triage work efficiency, and preexamination triage quality.
论著

眼科日间病房护理质量指标的构建

Establishing nursing quality indicators for ophthalmic intra-day ward

:558-563
 
目的:构建眼科日间病房护理质量指标,为眼科日间病房的护理质量管理提供理论依据。方法:以Donabedian三维质量结构模式为理论框架,通过查阅文献、小组讨论,初步拟定眼科专科护理质量评价指标。通过专家函询,对指标进行筛选和修订,确定了眼科日间病房护理质量指标。结果:经过2轮函询,专家意见趋向一致,2轮问卷回收率均为100%,协调系数分别为0.129、0.342(P<0.01)。构建的眼科专科护理质量指标包括3项一级指标,分别为结构指标(二级指标2项)、过程指标(二级指标8项)和结果指标(二级指标3项)。结论:该指标具有较高的科学性、可靠性、可行性以及专科特色,可为眼科日间病房护理质量的评价提供良好的方法。
Objective: To set up nursing quality indicators for ophthalmic intra-day ward, providing theoretical basis for nursing quality management in ophthalmic intra-day ward. Methods: Based on the "Donabedian three dimensional quality structure model" as the theoretical framework, the preliminary ophthalmic specialized nursing quality assessment indicators were designed by literature review and group discussion. The ophthalmic nursing quality indicators for intraday ward were finalized by expers consultated, indicators screened and revised. Results: After two rounds of inquration by letters, the opinions from the experts were consistent. Questionnaire response rates were both 100% in two rounds, with coordination coefficients of 0.129 and 0.342 respectively (P< 0.01). The nursing quality indicators for ophthalmic intra-day ward were established, including 3 primary indicators, which are structual indicators (2 secondary indicators), process indicators (8 secondary indicators) and outcome indicatiors(3 secondary indicators). Conclusion: The indicators are scientific, reliable, feasible with specialized characteristics, which can provide a good reference for evaluating the nursing quality in ophthalmic intra-day wards.
论著

SBAR沟通模式在眼球穿通伤急诊患者护理交接班中的应用

Application of SBAR communication model on nursing handover in patients with penetration injuries of eyeball

:237-241
 
目的:探讨标准化沟通模式(SBAR)在眼球穿通伤患者护理交班中的应用效果。方法:60例患者作为对照组,使用传统口头方式交班;60例患者作为观察组,使用SBAR沟通模式进行交接。比较两组交班耗时、两组护士对患者病情掌握程度以及患者对护理服务满意度的差异。结果:观察组与对照组比较,上述指标差异具有统计学意义(P<0.05)。结论:采取SBAR沟通模式交班有助于降低在眼球穿通伤护理中的不良事件发生率,保障了护理质量,提高了交接班效率和患者满意度,适宜推广应用。
Objective: To evaluate the SBAR communication model in the nursing care handover of patients with penetration injuries of eyeball. Methods: Transfer time, receivers’ information retention, and patient’s satisfaction were compared between two groups of patients with penetration injuries of eyeball. A total of 60 patients were handled with the traditional oral communication handover as comparison group and other 60 patients were handled with the SBAR handover as intervention group. Results: When comparing intervention group with comparison group, statistically significant improvements (P<0.05) were observed in all three factors tested. Conclusion:Implementing the communication tool SBAR in the nursing care of patients with penetration injuries of eyeball reduces rate of adverse events, improves patient care quality, enhances transfer efficiency, and boosts patient’s satisfaction.
论著

眼专科医院患者突发急症分析

Analysis of medical emergencies of patients in ophthalmic hospitals

:792-797
 
目的:分析眼专科医院患者突发急症现状,并探讨防控措施。方法:回顾性分析2017—2018年中山眼科中心82例突发急症事件,具体分析突发急症事件的特点、处置情况及患者转归。结果:眼专科医院中最常见的突发急症事件为药物不良反应(n=38,46.3%),其后依次是晕厥(28.0%)、心脑血管急症(8.3%)、意外事件(6.1%),其中药物不良反应涉及的相关药物最多见于荧光素钠注射液(n=16,42.1%)、局部神经阻滞麻醉相关药物(n=7,18.4%)。突发急症事件集中分布于工作时段8:00—18:00(n=74,91.3%),非工作时段多见于药物不良反应(n=3,42.9%)及心脑血管急症(n=3,42.9%)。门诊是突发急症事件最常发生的场所(n=53,64.6%),其后依次是住院病房(22.0%)、手术室(11.0%)。患者突发急症危急程度轻、中、重度分别占92.7%,4.9%,2.4%。50%的患者需要综合医院急诊人员配合抢救或至综合医院进一步诊治。结论:通过优化患者诊治流程,缩短在院时间,医护人员提高预警意识,明确各岗位潜在急症风险,可降低突发急症事件发生风险。发挥麻醉师专业优势,提高院内应急处理能力,同时签约定点综合医院急救服务,为患者提供快速、准确、高效的救护,保障患者生命安全。
Objective: To analyze the status of medical emergencies of patients in ophthalmic hospitals and put forward suggestions on their prevention and control measures. Methods: The medical emergencies of 82 patients in ophthalmic hospitals in 2017 and 2018 was been analyzed retrospectively, and the characteristics and treatment of emergencies as well as the metastasis and progression of the disease in patients were analyzed specifically.Results: Medical emergencies were caused by druginduced adverse reaction (n=38, 46.3%), syncope (28.0%), cardiovascular emergency (8.3%), accidents (6.1%) in sequence. Fluorescein sodium (n=16, 42.1%) and local anesthesia drugs for nerve block (n=7, 18.4%) were the most common drugs related to drug adverse reaction. Most cases happened at 8:00—18:00 (n=74, 91.3%), and drug adverse reaction and cardiovascular and cerebrovascular emergencies were most common at 18:00—8:00. Medical emergencies happened in outpatient department (n=53,64.6%), wards (22.0%) and operation rooms (11.0%). There were mild emergencies (92.7%), moderate emergencies (4.9%) and severe emergencies (2.4%) in patients. Among them, 50% of patients need first aid by doctors from general hospitals or to be transferred to the general hospital for further treatment. Conclusion: Through optimizing process, shortening the hospital stay, identifying potential risks and enhancing medical workers’ awareness of safety, the risk of medical emergencies can be reduced. We should give full play to the professional advantages of anesthesiologists,improve the emergency handling capacity of the hospital, and contract the emergency services of designated general hospitals to provide rapid, accurate and efficient rescue for patients to ensure the life safety of patients.
发明与创新

一种眼部化学伤结膜囊冲洗器

Application of conjunctiva sac irrigation device for ocular chemical injuries

:558-560
 
为满足眼部化学伤患者高效急救的需要,发明一种眼部化学伤结膜囊冲洗器,包括进液管道,冲洗管道,手动加压球,流量调节器和结膜囊冲洗头,避免反复更换冲洗液,减少操作时间,同时有利于冲洗液快速大量聚集,为严重眼部化学伤的患者缩短急救等待时间;手动加压球的设置,实现了冲洗液重力基础上的加压冲洗,为患者眼部急救治疗效果提供了可靠保证。
A new conjunctiva sac irrigation device which includs a liquid inlet pipe, flush pipe, and a manual pressure device,a flow regulator and a flush filter was invented to meet needs of efficient first aid for ocular chemical injuries. It is worth noting to avoid changing fushing fliud frequently and shorten time of operation, which is beneficial to gather a lot of flushing fluid in a short time and shorten the first aid waiting time for patients with severe ocular chemical injuries. For this device, the design of manual pressure ball realizes presure flush based on the gravity of flushing fliud, which confirms a reliable effect on the acute treatment to patients' eyes.
技术交流

影响角膜异物剔除术预后的因素分析

Analysis of influencing factors of prognosis of corneal foreign body removal

:348-352
 
角膜异物是眼科急诊中常见病之一,不及时处置或处置不当会导致角膜不同程度的损伤,严重者可引起角膜感染、角膜穿孔等并发症,严重损害视功能。因此安全、高效地剔除角膜异物至关重要。本文从角膜异物的特点、伤后首诊时间、角膜合并感染以及角膜异物的剔除方法等方面对角膜异物剔除术预后的影响进行回顾总结,旨在为医护人员行角膜异物剔除时提供有用参考。
Corneal foreign body is one of common diseases in ophthalmic emergency. Improper handling can cause different degree of corneal injuries, even corneal infection, perforation and endophthalmitis. Therefore, it is essential to eliminate corneal foreign bodies safely and effectively. This article mainly summarizes the influence of the characteristics of the corneal foreign bodies, the first diagnosis time after injury, corneal co-infection and the methods of weeding out the corneal foreign bodies upon the clinical prognosis of corneal foreign body removal, aiming to provide useful reference for medical practitioners in removing corneal foreign bodies.
发明与创新

一种眼部化学伤结膜囊冲洗器

Application of conjunctiva sac irrigation device for ocular chemical injuries

:558-560
 
为满足眼部化学伤患者高效急救的需要,发明一种眼部化学伤结膜囊冲洗器,包括进液管道,冲洗管道,手动加压球,流量调节器和结膜囊冲洗头,避免反复更换冲洗液,减少操作时间,同时有利于冲洗液快速大量聚集,为严重眼部化学伤的患者缩短急救等待时间;手动加压球的设置,实现了冲洗液重力基础上的加压冲洗,为患者眼部急救治疗效果提供了可靠保证。
A new conjunctiva sac irrigation device which includs a liquid inlet pipe, flush pipe, and a manual pressure device, a flow regulator and a flush filter was invented to meet needs of efficient first aid for ocular chemical injuries. It is worth noting to avoid changing fushing fliud frequently and shorten time of operation, which is beneficial to gather a lot of flushing fluid in a short time and shorten the first aid waiting time for patients with severe ocular chemical injuries. For this device, the design of manual pressure ball realizes presure flush based on the gravity of flushing fliud, which confirms a reliable effect on the acute treatment to patients' eyes.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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