신속대응팀의 활성화 시간에 영향을 주는 요인
Factors Influencing the Activation Time of the Rapid Response Team
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목적 : 신속대응팀은 입원 환자의 증상과 징후를 감지하고 중재와 치료를 제공하는 환자 안전 시스템이다. 본 연구는 신속대응팀의 활성화 시간에 영향을 주는 요인을 분석했다. 방법 : 신속대응팀에서 활성화 되었던 환자의 전자 의무 기록을 분석 한 서술적 상관 관계 연구이다. 수집 기간은 2014년 1월부터 2017년 12월 까지다. 서울 C 대학교 S 병원에서 16 세 이상 환자를 대상으로 신속대응팀에서 활성화 한 278건의 데이터를 분석했다. 데이터 분석을 위해 SPSS 23.0 프로그램을 사용했다. 결과 : 신속대응팀 활성화 이유는 산소 포화도가 90.0 % 미만, 기타의 경우,의식 변화 순서였다. 활성화 된 환자의 가장 흔한 진단은 호흡 부전 (32.4 %)이었다. 평균 활성화 시간은 153.43 ± 286.05 분이었다. 활성화 시간은 경련 발생시에 가장 짧았다 (13.29±7.32 분). 신장 질환의 병력이 있는 환자 (B=0.58, p=.008), 수술을 받았던 환자 (B=0.55, p<.001), 담당의사가 일차적으로 중재 한 경우 (B=0.53 , p=.007) 활성화 시간은 길어진다. 반면 의식 변화가 있는 경우 (B=-0.51, p=.002), 산소 포화도가 90.0 % 이하 (B=-0.64, p<.001)면 활성화 시간이 짧아진다. 결론 : 연구 결과를 바탕으로 병동에서 악화 된 환자를 조기에 인지하여 신속대응팀의 효과적인 활성화에 도움이 될 것으로 기대한다.
Abstract
Purpose: The rapid response team is a patient safety system that detects symptoms and signs of deteriorating inpatients and provides intervention and treatment. This study analyzed the factors influencing the activation time of the team. Methods: This is a descriptive correlation study that analyzed the electronic medical records of patients activated by the rapid response team. The collection period was from January 2014 to December 2017. We analyzed 278 pieces of data activated by the rapid response team for patients aged 16 years or older at C University S Hospital in Seoul. We employed the SPSS 23.0 program for data analysis. Results: The reasons for activation of the rapid response team were oxygen saturation of less than 90.0%, other causes, and change in consciousness. The most common diagnosis of activated patients was respiratory failure (32.4%). The average activation time was 153.43±286.05 min. The activation time was shortest during convulsions (13.29±7.32 min). For patients with a history of kidney disease (B=0.58, p=.008), in case of surgery (B=0.55, p<.001), if the first symptom is mediated by the physician (B=0.53, p=.007) the active time is often extended. On the other hand, activation time is reduced when consciousness changes (B=-0.51, p=.002), especially when oxygen saturation is below 90.0% (B=-0.64, p<.001). Conclusion: Based on the results of the study, it is expected that patients deteriorating in the general ward would be recognized early, which will help in the effective activation of the rapid response team.
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