目的 探讨4R危机理论在构建急诊危重症患者院内转运流程中的应用效果。方法 采用便利抽样法选取2022年6-8月进行院内转运的462例急诊危重症患者为对照组，实施院内常规转运流程；选取2023年4-6月进行院内转运的482例患者为观察组，实施基于4R危机理论的院内转运流程，比较两组患者转运相关不良事件的发生率、转运安全措施执行率及转运时间。结果 流程实施后，观察组转运相关不良事件的发生率及转运至CT室、重症监护病房、导管室、手术室所需时间均低于或短于对照组（P＜0.05或P＜0.01），转运安全措施执行率高于对照组（P＜0.05），差异均有统计学意义。结论 基于4R危机理论构建的急诊危重症患者院内转运流程，能够有效缩短转运时间、减少不良事件的发生，并提升急诊护理的整体质量与安全水平。

Objective To evaluate the effectiveness of applying 4R crisis theory in establishing intra-hospital transfer procedures for critically ill emergency patients.Methods A convenience sampling method was used to select 462 critically ill emergency patients who underwent intra-hospital transfer from June to August 2022 as the control group,who followed the routine intra-hospital transfer process.Another 482 patients who underwent transfer from April to June 2023 were selected as the observation group,who followed the intra-hospital transfer process based on the 4R crisis theory.The incidence of transfer-related adverse events,the implementation rate of transfer safety measures,and the transfer time were compared between the two groups.Results After implementation,the observation group showed significantly lower incidence of transfer-related adverse events and shorter transfer times to CT room,ICU,catheterization lab,and operating room compared to the control group (P＜0.05 or P＜0.01).The implementation rate of safety measures was significantly higher in the observation group (P＜0.05).Conclusions The 4R crisis theory-based intra-hospital transfer procedures for critically ill emergency patients can effectively reduce transfer time,decrease adverse events,and improve overall quality and safety of emergency care.

R472.2;R47-05

上海浦东新区卫生健康委员会重点薄弱学科建设项目（PWZbr2022-04)；同济大学医学院学科建设三年行动计划重点学科项目（JS2210103）；上海市东方医院天使计划和青年护士成长计划（DFTS-2201）