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.
随着人口老龄化、生活方式的改变，眼科疾病患病人数的增加、国家眼病诊疗相关政策的持续推动、居民健康意识的逐渐提升，眼科门急诊患者数量持续增长，亟需构建科学的眼科急诊预检分诊标准，合理配置医疗资源，确保患者得到及时、恰当的治疗。国外已有医院依据患者症状或体征的严重程度对患者进行等级划分，建立起相对成熟的眼科急诊预检分诊模式，我国目前尚没有统一的、权威的眼科急诊预检分诊标准，国内外现行的眼科急诊预检分诊模式的分诊精准度及临床适用性有待进一步探索。该文通过综述国内外眼科急诊分诊标准及应用评价、眼科远程急诊预检分诊方式研究进展，以期为构建符合我国国情的、科学有效的眼科急诊预检分诊标准、提高眼科急诊分诊质量提供参考。
With the aging of population, the changing of lifestyle and the increasing number of ophthalmic emergency patients,Chinese national policies related to ophthalmic diagnosis and treatment are continually promoted, and residents' health awareness are gradually improved, the volume of ophthalmic outpatients and emergency patients continues to increase. It is urgent needed to establish scientific ophthalmic emergency pre-examination and triage criteria, to reasonably allocate medical resources, and to ensure that patients receive timely and appropriate treatment. The relatively mature ophthalmic emergency pre-examination and triage models with the severity of patients' symptoms or physical signs,have been established in foreign hospitals. Currently, there is no unified and authoritative ophthalmic emergency triage criteria in China. The accuracy and clinical applicability of the existing ophthalmic emergency triage models at home and abroad need to be further explored. This article reviewed the ophthalmic emergency triage criteria and application evaluation at home and abroad, and remote emergency triage in ophthalmology, in order to provide a reference for establishing a scientific and effective ophthalmic emergency triage criteria comformed Chinese national conditions, and improving the quality of ophthalmic emergency triage.
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.
目的：探索基于眼外伤急诊救治胜任力的教学模式。方法：通过分析眼外伤急诊救治的教学现状，结合医学生岗位胜任力特征，构建基于眼外伤急诊救治胜任力的教学体系。结果：基于胜任力构建的眼外伤急诊救治教学体系的优势在于一切以临床实际需求为出发点，使学生在临床实践能力、思辨能力、团队合作、自我认知、医学人文素养等几个方面得到提升，从而更好地胜任临床工作。结论：基于胜任力的教学模式可以全面提高培训医师眼外伤急诊救治的实际能力。
Objective: To explore the teaching mode based on competency in emergency treatment of ocular trauma.Methods: By analyzing the teaching status of emergency treatment for ocular trauma and combining with the competency characteristics of medical students, a competency-based teaching system for emergency treatment of ocular trauma was constructed. Results: The advantage of the teaching system for emergency treatment of ocular trauma based on competency was that it took actual clinical needs as the starting point, which could improve students’ clinical practice ability, critical thinking ability, team work, self-cognition, medical humanistic quality and other aspects, so as to be better qualified for clinical work. Conclusion: The teaching mode based on competency can comprehensively improve the practical ability of training doctors in emergency treatment of ocular trauma.
