实用老年医学 ›› 2025, Vol. 39 ›› Issue (6): 636-640.doi: 10.3969/j.issn.1003-9198.2025.06.021

• 护理园地 • 上一篇    下一篇

基于早期预警评分的临床决策支持系统在老年急性主动脉夹层病人中的应用

杨光, 陈玉红, 冯萍, 李锡涵, 李格   

  1. 210006 江苏省南京市,南京医科大学第三临床医学院(杨光,李锡涵,李格);210006 江苏省南京市,南京医科大学附属南京医院护理部(陈玉红);重症医学科(冯萍)
  • 收稿日期:2024-12-09 出版日期:2025-06-20 发布日期:2025-07-07
  • 通讯作者: 陈玉红,Email:18951670955@163.com

Application of a clinical decision support system based on early warning scores in preoperative nursing care for elderly patients with acute aortic dissection

YANG Guang, CHEN Yuhong, FENG Ping, LI Xihan, LI Ge   

  1. Third Clinical Medical College, Nanjing Medical University, Nanjing 210006, China(YANG Guang, LI Xihan, LI Ge) ; Nursing Department(CHEN Yuhong); Intensive Care Unit(FENG Ping), the Affiliated Nanjing Hospital of Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China
  • Received:2024-12-09 Online:2025-06-20 Published:2025-07-07
  • Contact: CHEN Yuhong, Email: 18951670955@163.com

摘要: 目的 探讨基于早期预警评分的临床决策支持系统在老年急性主动脉夹层病人术前护理中的应用效果。 方法 构建包括监测评估模块、风险预警模块、决策支持模块等功能的急性主动脉夹层术前护理临床决策支持系统,比较系统应用前(对照组)和系统应用后(试验组)老年急性主动脉夹层病人在手术等待期的病情恶化事件发生率,目标心率、血压达标率,目标镇痛、镇静达标率;并收集ICU护士对该系统的有效性评价。 结果 纳入对照组51例,试验组53例。基于早期预警评分的临床决策支持系统应用后,试验组在手术等待期的病情恶化事件发生率较对照组降低(P<0.05),目标心率、血压、镇痛、镇静达标率均较对照组提高,差异均具有统计学意义(P<0.05)。ICU护士对该系统的有效性评价得分为(96.84±6.36)分。 结论 基于早期预警评分的临床护理决策支持系统能辅助护士识别老年急性主动脉夹层病人的潜在风险,并提供科学的决策依据,提高病人在术前等待期的安全性。

关键词: 临床决策支持系统, 早期预警评分, 急性主动脉夹层, 老年人, 护理

Abstract: Objective To evaluate the effectiveness of a clinical decision support system (CDSS) based on early warning scores in optimizing preoperative nursing care for the elderly patients with acute aortic dissection (AAD). Methods A preoperative nursing CDSS for AAD was developed, featuring modules including monitoring and assessment, risk warning, and decision support. The incidence of AAD deterioration during the preoperative waiting period, target achievement rates of heart rate, blood pressure, analgesia and sedation were recorded and compared before and after system implementation. Additionally, ICU nurses’ evaluation of the system’s effectiveness was collected and analyzed. Results After the implementation of the CDSS, the incidence rate of disease deterioration events during the preoperative waiting period was significantly decreased(P<0.05), and the target achievement rates of heart rate, blood pressure, and analgesia and sedation showed significant improvement (P<0.05). The score of the effectiveness of the system evaluated by ICU nurses was 96.84±6.36. Conclusions The CDSS based on early warning scores effectively helps the nurses identify potential risks in elderly AAD patients and provides scientific support for decision-making. The implementation of this system significantly enhances the patients’ safety during the preoperative waiting period.

Key words: clinical decision support system, early warning score, acute aortic dissection, aged, nursing care

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