Risk Factors For Security Transport Of Adult Patients In Emergency Department Inside Hospital And The Application Of MEWS

Objective To determine the risk factors of nosocomial security transport for adult patients in emergency department,and modifing early warning score application of nosocomial transhipment for adult patients in emergency department.Methods The experiment included two parts: experiment I : 512 adult patients in a Tianjin 3A grade hospital emergency department from June 2014 to November 2014 were enrolled in the study. They are in need of diagnosis and treatment in nosocomial transshipment. According to whether or not adverse event occurred within nosocomial transhipment time,the patients were divided into A group or B group. The security situation of 300 cases of patients with nosocomial transshipment were divided into the B group(n=300) and the else cases were divided into the A group(n=212). Cases data of 512 adult patients were retrospectively analyzed.General condition, special circumstances and vital signs of questionnaires before nosocomial transshipment, the circumstances of malignant events such as dropping bed or IV tubes and various kinds of drainage tube jam or escape, shock, suffocation and death, and patients information from. receiving department were recorded. The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify nosocomial security transport-related risk factors for this type of patients. Experiments Ⅱ:118 patients of both sexes, aged ≥18 yr,who are in need of diagnosis and treatment in nosocomial transshipment, were randomly divided into two groups using a random number table: routine transport group(Group C) or MEWs group. Conventional transhipment in Group C was performed while MEWS group is adopted to improve the ratings on the basis of conventional nursing according to the different arrangement of different levels of nursing implementation. Two groups of patients with adverse events occurring during nosocomial transshipment, the total time to the destination, nursing disputes occur and satisfaction between departments were recorded.Resluts: Experiment Ⅰ:There was significant difference in the parameters of age,illness severity, escort person, assisted ventilation, transport vehicles, carrying drugs and items and carrying channel(P<0.05). logistic regression indicated that age,illness severity(Ⅰ grade,Ⅱ grade), escort person(auxiliary nurse), assisted ventilation, transport vehicles(wheelchair),not carrying drugs and items and carrying channel were the risk factors for nosocomial security transport in emergency department.While the escort person(The secondary nurses and above), not assisted ventilation, transport vehicles(platform wagon), and carrying drugs and items were the protective factors for nosocomial security transport in emergency department. Experiment Ⅱ:Compared with group C,the incidence of transit adverse events were decreased,the time of nosocomial transport was shorten,and more satisfaction between departments, more satisfaction with patients and their families in Group MEWS(P<0.05).Conclusion: Age,illness severity, escort person, assisted ventilation, transport vehicles,not carrying drugs and items and carrying channel were the risk factors for nosocomial security transport in emergency department.while reducing the incidence rate of patients with adverse complications,less time with destination, lower incidence of nursing disputes, more satisfaction between departments, more satisfaction with patients and their families with MEWS scoring system. The system was applied to emergency apartment for patients while training the nurse skills, keeping good communicate with the patients and their families,popularizing the illness can give the right scheme qucikly, save time, reduce the risk and improve the incidence of rescuing.