Effectiveness Research On Re-engineering Of Hemoperfusion Emergency Process In The Treatment Of Acute Poisoning

Objective Study retrospectives analysis of the current situation of the routine treatment process for acute poisoning patients with hemoperfusion,compares the difference between the time of patients started hemoperfusion and the recommended time of the guidelines,and analyzes the defects of the original process to provide a basis for process re-engineering.Re-engineering of the hemoperfusion emergency process,and exploring its application and efficacy in clinic.Methods 1.Retrospective analysis of 30 cases of acute poisoning patients with hemoperfusion in a class A hospital from June to December 2017 and use a self-designed form to investigate the patient's research indicators:?Patients 'general information includes age,sex,occupation,education,past history,toxicology type,exposure time,APACHE ?score,and patients 'state of consciousness;?time indicators for each segment:first hemoperfusion time,hospital waiting time before hemoperfusion,time to enter EICU,entry into EICU to start hemoperfusion time;?clinical indicators:time of consciousness of patients with mental impairment,total number of days in hospital,including EICU hospitalization days and general ward hospitalization days.Then analyze the weakness of routine treatment process in practical application.2.Re-engineering and application of hemoperfusion emergency process.30 cases with acute poisoning patients treated with hemoperfusion were collected from February to August 2018 in a grade A tertiary hospital,and compare with the quality index before the process re-engineering in the first part.Results Through a retrospective analysis of the first part of the study,it was found that the first hemoperfusion time was 7.5(6,9.37)h.The results were somewhat different from the 4-6H recommended by the 2017 "Expert Consensus on Clinical Application of Blood Cleansing".The original routine nursing procedure includes the emergency nursing procedure for acute poisoning in the emergency rescue room and the normal flow of hemoperfusion in EICU.The two processes are applicable to different patients,and are not suitable for acute poisoning patients with hemoperfusion The original routine nursing procedure needs to be integrated and reconstructed.There were no significant differences in age,sex,occupation,education,past history,toxicology type,exposure time,APACHE II score and patients 'state of consciousness in the two groups(P>0.05).The first hemoperfusion time was shortened from 7.5(6,9.37)h to 5(4,6.31)h;The hospital waiting time before hemoperfusion was shortened from 4(3.25,4.63)h to 2.28(1.75,3.13)h;Entry into EICU to start hemoperfusion time was shortened from 2(1.5,2.74)h to 0.84(0.67,1.06)h;The total number of days in hospital was reduced from 12.5(10,16.5)days to 10(8.75,11.25)days;EICU hospitalization days were reduced from 6(5,9)days to 5(4,5)days;General ward hospitalization days was reduced from 7(5.5,9.5)days to 5(4,6.25)days.The above indexes of two groups were statistically significant(P<0.01).Through process re-engineering,the time of consciousness of patients with mental impairment was shortened from 39.05(27.63,47.3)h to 13.5(9.25,42.65)h,and the Mann-White Test difference was statistically significant(Z =-2.143,P = 0.032).There was no statistically significant difference between the two groups in the time to enter EICU(Z ?-1.622,P = 0.105).Conclusion Through process re-engineering,it integrated the emergency rescue room and EICU two major emergency procedures for acute poisoning patients with hemoperfusion,and combined the treatment work of the rescue room and EICU in two different regions to achieve Seamless connection.The reconstructed hemoperfusion process gives priority to the installation and pre-rush of blood irrigation,and the treatment of blood irrigation is given priority over hospital care operations.lt shortened the first hemoperfusion time,reduced the hospital days,shortened the time of consciousness of patients with mental impairment,improved the efficiency of rescue,and made the treatment work more efficient,rational,and scientific.This re-engineered hemoperfusion emergency process has achieved good results and can meet clinical needs.It is worth popularizing in clinical nursing.