Background Effective team leadership and good activation criteria can effectively initiate rapid response system (RRS) to reduce hospital mortality and improve quality of life. The first reaction time of nurses plays an important role in the rescue process. To construct a nurse-led (nurse-led RRS) and activation criteria and then to conduct a pragmatic evaluation of the nurse-led RRS. Methods We used literature review and the Delphi method to construct a nurse-led RRS and activation criteria based on the theory of “rapid response system planning.” Then, we conducted a quasi-experimental study to verify the nurse-led RRS. The control group patients were admitted from August to October 2020 and performed traditional rescue procedures. The intervention group patients were admitted from August to October 2021 and implemented nurse-led RRS. The primary outcome was success rate of rescue. Setting Emergency department, Gansu Province, China. Results The nurse-led RRS and activation criteria include 4 level 1 indicators, 14 level 2 indicators, and 88 level 3 indicators. There were 203 patients who met the inclusion criteria to verify the nurse-led RRS. The results showed that success rate of rescue in intervention group (86.55%) was significantly higher than that in control group (66.5%), the rate of cardiac arrest in intervention group (33.61%) was significantly lower than that in control group (72.62%), the effective rescue time of intervention group (46.98 ± 12.01 min) was shorter than that of control group (58.67 ± 13.73 min), and the difference was statistically significant ( P < 0.05). The rate of unplanned ICU admissions in intervention group (42.85%) was lower than that in control group (44.04%), but the difference was not statistically significant ( P > 0.05). Conclusions The nurse-led RRS and activation criteria can improve the success rate of rescue, reduce the rate of cardiac arrest, shorten the effective time of rescue, effectively improve the rescue efficiency of patients.

目的 通过科学的研究方法,构建急诊护理质量敏感指标,为急诊临床实践提供科学、可测量的质量监测工具.方法 以文献循证为基础,通过专家访谈和Delphi法对46名专家进行2轮问卷咨询,确定符合临床实践的指标体系.结果 专家咨询的权威系数为0.93,判断系数0.96,熟悉程度0.89.2轮专家咨询后抢救室、监护室和观察室敏感指标的协调系数分别为0.364、0.443和0.516,P<0.05,具有统计学意义,认为专家咨询的协调程度好.指标体系包括3个一级指标、5个二级指标和15个三级指标.结论 急诊护理质量敏感指标体系各级指标的条目专家意见集中,研究结果可信度高,为急诊护理质量的考核、岗位设置、流程优化提供了客观的依据.

目的 探讨有意性急性农药中毒相关因素,为该病的预防和健康促进提供依据.方法 应用《有意性急性农药中毒相关因素调查问卷》,对甘肃省有意性急性农药中毒患者和同期非急性农药中毒患者进行调查.采用结构方程模型分析结果.结果 认知因素、社会环境因素、心理因素对中毒行为的发生有直接影响,标准化回归系数分别为-0.831、-0.752和-0.469;认知因素对心理因素和社会环境因素有直接作用;二级维度中认知偏差、绝对化、应对方式、社会支持、农药管理和负性生活事件对中毒行为的发生有间接作用,标准化系数分别为0.757、0.541、0.773、0.576、0.824和0.782.结论 关注有意性急性农药中毒发病的相关因素,改善其社会学相关因素及应对方式,给予社会支持,加强农药管理,有助于降低发生率.