طراحی و به کارگیری چک‌لیست بررسی وضعیت انتقال درون بیمارستانی بیماران COVID-19 مراجعه‌کننده به بخش‌های اورژانس

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه مراقبت‌های ویژه‌ی پرستاری، دانشکده‌ی پرستاری و مامایی و مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، پژوهشکده‌ی پیش‌گیری از بیماری‌های غیر واگیر، دانشگاه علوم پزشکی قزوین، قزوین، ایران

2 دانشیار، گروه طب اورژانس، دانشکده‌ی پزشکی و مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، پژوهشکده‌ی پیش‌گیری از بیماری‌های غیر واگیر، دانشگاه علوم پزشکی قزوین، ایران

3 دانشجوی کارشناسی ارشد، گروه مراقبت‌های ویژه‌ی پرستاری، کمیته‌ی تحقیقات دانشجویی، دانشکده‌‌ی پرستاری و مامایی، دانشگاه علوم پزشکی قزوین، ایران

چکیده

مقدمه: در زمان انتقال بیماران بستری شده به دلیل Coronavirus disease 2019 (COVID-19) در بیمارستان‌ها، لازم است تمهیدات مناسب جهت حفظ ایمنی بیماران و کارکنان رعایت شود. این پژوهش با هدف طراحی چک‌لیست و بررسی وضعیت انتقال درون بیمارستانی این بیماران در بخش‌های اورژانس انجام شد.روش‌ها: در این مطالعه‌ی مقطعی، چک‌لیست ارزیابی وضعیت انتقال درون بیمارستانی بیماران مبتلا به COVID-19، طراحی و مورد ارزیابی قرار گرفت. چک‌لیست اولیه‌ی انتقال درون بیمارستانی، بر اساس داده‌های دستورالعمل‌ها و مقالات منتشر شده در رابطه با بیماران COVID-19 تهیه گردید. اعتبار چک‌لیست مذکور با استفاده از روایی صوری (توسط 20 نفر از پرستاران اورژانس) تأیید شد. سپس گویه‌ها از نظر روایی محتوایی به دو روش کمی و کیفی مورد ارزیابی قرار گرفت. به منظور بررسی روایی محتوا به روش کمی، از ضریب نسبت روایی محتوا (Content validity ratio یا CVR) و شاخص روایی محتوا (Content validity index یا CVI) استفاده گردید. جهت تعیین CVR و CVI، به ترتیب از پانل خبرگان و روش Waltz و Bausell استفاده شد. با استفاده از چک‌لیست نهایی، وضعیت انتقال بیماران COVID-19 در سه مرحله (قبل، حین و بعد از انتقال) توسط سه نمونه‌گیر از اردیبهشت تا شهریور سال 1399، در بخش‌های اورژانس بیمارستان‌های منتخب شهر قزوین مورد بررسی قرار گرفت.یافته‌ها: در تحقیق حاضر، نحوه‌ی انتقال 167 بیمار طی 501 بار مشاهده، بررسی گردید. خطاها در 9/50 درصد از انتقال‌ها به ویژه در حین انتقال (9/32 درصد) رخ داده بود که از مهم‌ترین موارد می‌توان به افت فشار اکسیژن خون شریانی، کاهش و افزایش فشار خون، عدم رعایت پروتکل‌های انتقال از جمله عدم ضد عفونی مسیرهای انتقال (7/73 درصد)، عدم رعایت بهداشت دست (6/74 درصد) و عدم تعویض وسایل حفاظت فردی (5/60 درصد) اشاره نمود.نتیجه‌گیری: بیشترین حادثه به ترتیب کاهش درصد اشباع اکسیژن خون شریانی و کاهش فشار خون بود که از نظر زمانی به طور عمده در زمان انتقال بیماران به وقوع پیوسته بود.

کلیدواژه‌ها

عنوان مقاله [English]

Designing and Assessment of a Checklist for Transfer Status of Patient with COVID-19 Referred to Emergency Departments

نویسندگان [English]

  • Leili Yekefallah 1
  • Peyman Namdar 2
  • Roghayeh Asgari 3
1 Associate Professor, Department of Critical Care Nursing, School of Nursing and Midwifery AND Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
2 Associate Professor, Department of Emergency Medicine, School of Medicine AND Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
3 MSc Student, Department of Critical Care Nursing, Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
چکیده [English]

Background: When transferring patients admitted to hospitals due to coronavirus disease 2019 (COVID-19), it is necessary to take appropriate measures to maintain the safety of patients and staff. The aim of this study was to design a checklist and evaluate in-hospital transfer status of patients with COVID-19 disease in emergency departments.Methods: In this cross-sectional study, a checklist for evaluation of in-hospital transfer of patients with COVID-19 in the emergency department was designed, and then assessed. The initial in-hospital transfer checklist was prepared based on data from guidelines and published articles regarding patients with COVID-19. Its validity was confirmed using face validity (by 20 emergency nurses). Then, the items were evaluated in terms of content validity in both quantitative and qualitative methods. To evaluate the content validity in a quantitative way, the content validity ratio (CVR) coefficient and the content validity index (CVI) were used. Waltz and Basel methods were used to determine CVR from the panel of experts and for CVI, respectively. Using the final checklist, the transfer status of patients with COVID-19 in three stages (before, during, and after transfer) by three samplers, from May to September 2020, in the emergency departments of selected hospitals in Qazvin City, Iran.Findings: In this study, the modes of transmission of 167 patients during 501 observations were investigated. Errors occurred in 50.9% of transfers, especially during transfer (32.9%), the most important cases of which included reduction of arterial blood oxygen saturation, decrease and increase in blood pressure, and incompliance with transfer protocols including non-disinfection of transmission routes (73.7%), lack of hand hygiene (74.6%), and non-replacement of personal protective equipment (60.5%).Conclusion: The results of the study showed that the most accidents were reduction of arterial blood oxygen saturation and hypotension, respectively, which occurred in terms of time, mainly during patient transfer.

کلیدواژه‌ها [English]

  • Patient transfer
  • COVID-19
  • Checklist
  • Medical Errors

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سابقه مقاله

  • تاریخ دریافت: 24 بهمن 1399
  • تاریخ بازنگری: 01 تیر 1402
  • تاریخ پذیرش: 17 فروردین 1401

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