急诊科拥挤对急诊临床实践的影响

摘要

急诊科拥挤问题已经成为了一个世界性的危机，严重影响了急诊医疗服务质量。研究表明，拥挤的急诊科救护车转向率和未看医生离开急诊现象发生率较高，可引起急性心肌梗死、缺血性脑卒中等时间敏感性疾病治疗的延迟，导致更差的临床预后，增加临床用药错误的发生率，降低患者对急诊的满意度。另外还有资料显示，急诊科拥挤对急诊医师的培养也会产生不利影响。评估和缓解急诊科拥挤主要集中在入口环节、处置过程和出口环节三个部分，但到目前为止，还没有有效的评估和缓解策略。%Emergency department (ED) crowding represents a worldwide crisis, which may seriously affect the access and quality of health care .The most important themes include the increases of ambulance diversion and leaving without being seen , the delays in care for time -sensitive diseases such as acute myocardial infarction and stroke .It contributes to various adverse outcomes , medical errors and low patient satisfaction . The ED crowding also influences the emergency resident training .The assessment and mitigation strategies are focus on input ,throughput and output parts .However,there are no effective strategies till now .