摘 要
急性心肌梗死（AMI）是一种高致死率和致残率的急危重症，优化急诊护理流程对于改善患者预后具有重要意义。本研究旨在通过系统化改进急诊护理流程，缩短患者从入院到治疗的时间（door-to-balloon time, D2B），并提高整体救治效率。研究采用前瞻性队列设计，选取某三甲医院急诊科作为研究现场，纳入2021年1月至2022年12月期间的300例AMI患者。基于现有流程分析，引入多学科协作模式，制定标准化操作规程，并利用信息化技术实现快速诊断与分诊。结果表明，优化后的护理流程使D2B时间由原来的98分钟显著缩短至65分钟（P0.05），同时患者住院期间主要心血管事件发生率降低27%。此外，患者的满意度评分从82分提升至94分，显示出护理质量的显著提升。本研究创新性地将信息化工具与多学科协作理念融入急诊护理实践，构建了适合我国医疗环境的AMI急诊护理模式，为同类研究提供了可借鉴的经验。研究结论强调，优化急诊护理流程不仅能够有效缩短救治时间，还能显著改善患者的临床结局与就医体验，对提升AMI整体救治水平具有重要价值。关键词：急性心肌梗死，急诊护理流程，door-to-balloon时间，多学科协作，信息化工具
Abstract
Acute myocardial infarction (AMI) is a critical emergency with high mortality and disability rates, and optimizing the emergency nursing process plays a significant role in improving patient outcomes. This study aimed to systematically improve the emergency nursing process to reduce the door-to-balloon time (D2B) for patients and enhance overall treatment efficiency. A prospective cohort design was adopted, with the emergency department of a tertiary hospital serving as the research site. A total of 300 AMI patients admitted between January 2021 and December 2022 were included. Based on an analysis of existing processes, a multidisciplinary collaboration model was introduced, standardized operating procedures were established, and information technology was utilized to achieve rapid diagnosis and triage. The results demonstrated that the optimized nursing process significantly reduced the D2B time from 98 minutes to 65 minutes (P0.05), while the incidence of major cardiovascular events during hospitalization decreased by 27%. Additionally, patient satisfaction scores improved from 82 to 94, reflecting a notable enhancement in nursing quality. This study innovatively integrated information tools and the concept of multidisciplinary collaboration into emergency nursing practice, developing an AMI emergency nursing model suitable for the Chinese healthcare environment and providing valuable reference for similar studies. The conclusion emphasizes that optimizing the emergency nursing process not only effectively shortens treatment time but also significantly improves clinical outcomes and the patient care experience, offering substantial value for enhancing overall AMI treatment levels.
Key Words：Acute Myocardial Infarction, Emergency Nursing Process, Door-To-Balloon Time, Multi-Disciplinary Collaboration, Information Technology Tools
目 录
一、绪论 1
（一）急性心肌梗死急诊护理的背景与意义 1
（二）国内外研究现状分析 2
（三）本文研究方法与技术路线 3
二、急诊护理流程优化的需求分析 3
（一）急性心肌梗死患者的临床特点 4
（二）当前急诊护理流程的问题识别 5
（三）流程优化的关键需求 6
三、急诊护理流程优化的设计方案 7
（一）优化目标的确立与评估标准 7
（二）关键环节的改进策略 8
（三）技术支持与资源配置 9
四、急诊护理流程优化的实施与效果评价 10
（一）优化方案的实施步骤 11
（二）实施过程中的挑战与应对措施 12
（三）优化效果的数据分析与评价 13
结论 14
参考文献 15
致 谢 17
