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与没有被看到的离开相关的因素在儿科急诊室的患者患者
Takashi Nihira1,2, Takateru Ihara1,3, Yuta Sasaoka1,4
1Department of Pediatric Emergency Care and Intensive Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, JPN.
Cureus
|January 7, 2025
概括
防止孩子在没有被看到的情况下离开 (LWBS) 是至关重要的. 敏度低,等待时间长,周末/晚上访问显著增加了儿科急诊室LWBS的风险.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗保健管理的管理
- 患者安全 患者安全
背景情况:
- 在儿科紧急护理中,没有被看到的离开 (LWBS) 存在风险,原因是儿童在寻求医疗保健方面的自主权有限.
- 在日本,关于LWBS的流行率和促成因素的数据有限,因此需要研究来了解其对医疗保健的影响.
- 这项研究通过在日本儿科三级保健机构中检查LWBS来解决这一差距.
研究的目的:
- 调查儿童患者在分拣后离开未被看到 (LWBS) 的发生率.
- 为了确定与日本儿科急诊部LWBS相关的关键因素.
- 为改善儿科急诊护理患者安全和资源配置提供数据.
主要方法:
- 使用了回顾性队列研究设计.
- 数据是从日本一家三级儿科医疗中心的电子管理数据库中提取的.
- 2014年4月至2017年3月期间出现的15岁或更年轻儿童的记录被分析为LWBS和相关因素.
主要成果:
- 总共有112,059名儿科患者被纳入,其中168名 (0.15%) 被确定为LWBS.
- 与LWBS显著相关的因素包括较低的分类敏度 (OR: 2.33),周末/假日访问 (OR: 1.71) 和晚上访问 (OR: 1.44).
- 长时间停留在急诊室 (EDLOS>1小时,OR:3.48) 和等待时间 (>1小时,OR:41.93) 与LWBS增加密切相关.
结论:
- 低患者敏度,非紧急访问时间 (晚上,周末/假日),长时间的EDLOS和延长的等待时间是儿科急诊护理中LWBS的重要预测因素.
- 这些发现与国际研究一致,表明导致LWBS的因素具有普遍性.
- 针对等待时间和高峰时段资源管理的干预措施可能会降低儿科LWBS的发病率.
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