Emergency treatment gynaecology and obstetrics pre-examination triage standard construction method

Abstract

The invention discloses an emergency treatment gynaecology and obstetrics pre-examination triage standard construction method which comprises the following steps: S1, determining a pre-examination triage standard which comprises a single objective index, a single subjective index and an emergency sign / condition index; s2, grading the pre-examination and triage standards through a hospital triage system, wherein the grading setting standards comprise an endangered grade requiring immediate pre-examination and triage, an emergency grade requiring pre-examination and triage within 10 minutes, an emergency grade requiring pre-examination and triage within 30 minutes and a non-emergency grade requiring pre-examination and triage within 60-120 minutes; s3, performing pre-practice on the pre-examination triage standard subjected to grade division; and S4, verifying the pre-examination triage standard subjected to pre-practice. The method has the advantages that the triage accuracy can be improved from 90.25% to 96.98%, the green channel opening time limit of the acute and critical patients can be shortened from 16.89 + / -9.701 min to 6.55 + / -2.012 min, and it is indicated that the method has the remarkable effect on the aspects of improving the triage efficiency and shortening the treatment time of the acute and critical patients.

Description

Technical Field

[0001] This invention relates to the field of emergency triage technology, and in particular to a method for constructing emergency obstetrics and gynecology triage standards. Background Technology

[0002] Maternal and infant health is an important indicator of a society's overall healthcare level and quality of life. International health organizations primarily focus on three core metrics when assessing the health status of residents in different countries: life expectancy, newborn survival rate, and maternal safety index.

[0003] In maternal and child health hospitals, the emergency obstetrics and gynecology department is a relatively independent department with a high risk factor, accounting for approximately 50% of all patients. Women of childbearing age have strong physiological and metabolic functions, leading to rapid onset and acute illness. The conditions of pregnant women seeking treatment can change rapidly, threatening the lives of both mother and baby if not treated promptly, and causing conflicts between nurses and patients. From 2008 to 2020, medical disputes in obstetrics and gynecology departments of tertiary-level Class A hospitals in my country accounted for 10.2%, ranking third among medical disputes. Among all medical disputes in maternal and child health hospitals in my country, obstetrics and gynecology-related disputes account for 64.3%.

[0004] With the adjustment of my country's birth control regulations and the gradual relaxation of the two-child and three-child policies, the fertility rate of older women has increased significantly. The US Vital Statistics report shows that the fertility rate of women aged 35-39 increased by 5% in 2021. In my country, the proportion of abnormal pregnancies, such as advanced maternal age, women with scarred uteruses, and women who have had multiple pregnancies through assisted reproductive technology, is increasing. Some multiparous women have lower adherence to prenatal checkups, medical treatment, and doctor's orders, and their physical condition is generally worse than that of first-time mothers. Therefore, the incidence of maternal complications, the complexity of conditions, and precipitous labor in the pre-hospital and emergency departments has increased significantly. According to statistics from my country's National Health and Family Planning Commission, six months after the full implementation of the two-child policy in 2016, the maternal mortality rate increased by 30.6% compared to the same period in 2015. The total number of maternal deaths in my country each year is 3.5 times that of developed countries.

[0005] Although a pregnant woman's condition can change rapidly, early identification of acute and critical signs and effective intervention can prevent potential risks and reduce maternal mortality. In developed countries like the UK and the US, 40%–60% of maternal deaths can be prevented through timely intervention. In clinical practice, the process from the onset of illness to death involves identification and diagnosis. Failure to promptly identify and diagnose changes in a pregnant woman's condition will delay treatment and resuscitation. Therefore, the efficient, rapid, and accurate identification of potential risks in acutely ill pregnant women by triage nurses, and the immediate implementation of appropriate interventions, are crucial to ensuring the quality of life for pregnant women.

[0006] Emergency triage prioritizes patients in the emergency department, ensuring that those requiring immediate intervention receive medical care. Triage personnel assess patients using triage forms and their individual circumstances, then triage them to the appropriate areas, with a particular focus on identifying critically ill patients for priority diagnosis and treatment. Epidemiological data shows that approximately 25% of women of childbearing age in my country have high-risk pregnancies, and about 15% of these pregnancies may result in life-threatening complications that can lead to serious long-term health consequences. Given the special and urgent nature of these patients, establishing a standardized and scientific triage assessment system in the emergency obstetrics and gynecology department is crucial. This not only helps triage nurses quickly identify critically ill patients but also ensures timely initiation of appropriate nursing interventions, thereby effectively reducing the incidence of adverse pregnancy outcomes.

[0007] In response, the inventor of this patent, combining clinical experience, reflecting on problems encountered in clinical work, reviewing a large amount of scientific research data and literature, and conducting a novelty search, gradually conceived, designed and demonstrated the feasibility of this application in order to solve the relevant technical problems. Summary of the Invention

[0008] This invention aims to at least partially solve one of the technical problems in related technologies. Therefore, the objective of this invention is to propose a method for constructing a triage standard for emergency obstetrics and gynecology departments.

[0009] To achieve one of the above objectives, a method for constructing emergency obstetrics and gynecology triage standards according to an embodiment of the present invention includes the following steps: S1. Determine the pre-examination and triage criteria, which include a single objective indicator, a single subjective indicator, and critical signs / condition indicators; The individual objective indicators include: consciousness, signs of fetal distress, amniotic fluid properties, premature rupture of membranes, respiration, blood pressure, heart rate, shock index, blood oxygen saturation, and results of tests carrying critical values. The individual subjective indicators include: neurological complaints, amount of vaginal bleeding, frequency of regular uterine contractions, amount of vaginal fluid discharge, fetal movement, pain index, and chest discomfort; The critical signs / conditions include: cardiac and respiratory arrest, airway obstruction or suffocation, umbilical cord prolapse, fetal limb prolapse outside the cervix, severe abdominal pain in pregnant women, significant discomfort or uterine contractions in pregnant women after external impact to the abdomen or waist, vaginal bleeding, abdominal pain, painless vaginal bleeding in pregnant women with prenatal diagnosis of vasa previa, regular uterine contractions in placenta accreta, ovarian cyst torsion, ectopic pregnancy and corpus luteum rupture, persistent vomiting in pregnant women, gestational age ≥20 weeks and amniotic fluid index ≤5.0 on ultrasound, gestational age ≥20 weeks and diarrhea unrelated to diet, menstrual irregularities, and vaginitis. S2. The pre-examination and triage standards are classified into levels through the hospital triage system. The classification standards include the critical level that requires immediate pre-examination and triage, the acute and severe level that requires pre-examination and triage within 10 minutes, the emergency level that requires pre-examination and triage within 30 minutes, and the non-emergency level that requires pre-examination and triage within 60-120 minutes. S3. Conduct a preliminary trial of the triage criteria that have been graded to assess their reliability; S4. Validate the pre-tested triage criteria.

[0010] In addition, the method for constructing emergency obstetrics and gynecology triage standards according to the above embodiments of the present invention may also have the following additional technical features: According to an embodiment of the present invention, step S1 specifically includes: S11. Determine the inclusion and exclusion criteria for the literature, systematically search relevant databases of obstetrics and gynecology triage standards at home and abroad, and screen literature that meets the requirements; S12. Conduct methodological quality evaluation on the selected literature that meets the requirements, assess the rationality and scientificity of the research design, extract key research data and results through the design of standardized data extraction tables, organize and statistically analyze the data, and form a summary of evidence. S13. Establish an expert inquiry group and use the Delphi expert inquiry method to conduct an inquiry questionnaire survey on the collected evidence through experts. S14. Analyze and summarize the results of the questionnaire survey to derive the final pre-examination and triage criteria.

[0011] According to an embodiment of the present invention, in step S11, Inclusion criteria: The study type was original research, clinical research, observational research, and guidelines related to emergency obstetrics and gynecology triage; the study subjects were obstetrics and gynecology emergency patients, including pregnant women and gynecological emergency patients; the interventions were measures related to triage, including triage standards and emergency procedures; the outcome measures were triage accuracy, waiting time, patient satisfaction, and clinical outcomes. Literature exclusion criteria: duplicate publications, literature of low research quality, literature with incomplete data, and literature unrelated to the research topic.

[0012] According to one embodiment of the present invention, the critical levels requiring immediate pre-screening and triage include: sudden loss of consciousness or alteration in degree of consciousness in the pregnant woman (convulsions, drowsiness, syncope, disorientation, stupor, coma, etc.); signs of fetal distress manifested as a fetal heart rate consistently ≥160 bpm or ≤110 bpm, or an electronic fetal heart rate monitoring assessment of Category III; amniotic fluid characteristics manifested as bloody amniotic fluid, yellow-green turbid amniotic fluid, thick amniotic fluid, or brownish-yellow amniotic fluid; premature rupture of membranes manifested as premature rupture of membranes in breech, transverse, or other abnormal fetal positions; respiratory rate ≥30 breaths / min or ≤9 breaths / min; systolic blood pressure ≥160 mmHg or ≤75 mmHg; diastolic blood pressure ≥110 mmHg; heart rate ≥130 bpm or ≤40 bpm; shock index (heart rate / systolic blood pressure) >1.5; oxygen saturation ≤91% or pallor or cyanosis; and presence of critical value test results. The following are symptoms of pregnancy and related neurological symptoms: headache, blurred vision or dizziness, vaginal bleeding heavier than menstrual flow, regular uterine contractions ≤2 minutes / time in primiparous women with involuntary abdominal pressure, regular uterine contractions 3-4 minutes / time in multiparous women with involuntary abdominal pressure, excessive vaginal discharge, loss of fetal movement, pain index of 7-10, chest discomfort such as persistent retrosternal pain, cardiac and respiratory arrest, airway obstruction or suffocation, umbilical cord prolapse, fetal limb prolapse outside the cervix, severe abdominal pain in pregnant women (suspected uterine rupture / threatened uterine rupture / placental abruption / suspected surgical acute abdomen, such as pancreatitis), significant discomfort or uterine contractions or vaginal bleeding in pregnant women after external impact to the abdomen or waist, abdominal pain, painless vaginal bleeding in pregnant women with confirmed vasa previa, regular uterine contractions due to placenta accreta, ovarian cyst torsion, ectopic pregnancy, and ruptured corpus luteum.

[0013] According to one embodiment of the present invention, the acute and severe illness levels requiring pre-screening and triage within 10 minutes include: fetal distress signs assessed as Category II by electronic fetal heart rate monitoring; amniotic fluid characteristics as light green; premature rupture of membranes in twins; pregnant women ≤32 weeks of gestation with significant vaginal discharge and normal fetal heart rate; respiratory rate of 21-29 breaths / min; systolic blood pressure of 140-159 mmHg or 76-80 mmHg; and diastolic blood pressure of 100-109 mmHg. Hg, heart rate 110-129 bpm or 41-49 bpm, shock index 1 < ≤ 1.5, blood oxygen saturation 92-93%, vaginal bleeding equal to menstrual flow, regular uterine contraction frequency of 3-4 min / time for primiparous women, regular uterine contraction frequency of 5-10 min / time for multiparous women, little vaginal discharge, perceived decrease in fetal movement, pain index 4-6, chest discomfort manifested as intermittent retrosternal pain, scar pregnancy, ovarian stimulation syndrome, out-of-hospital delivery without treatment.

[0014] According to one embodiment of the present invention, the emergency levels requiring pre-screening and triage within 30 minutes include: fetal distress signs assessed as Class I by electronic fetal heart rate monitoring; premature rupture of membranes manifested as vaginal discharge and normal fetal heart rate in pregnant women with gestational age >32 weeks; systolic blood pressure of 81-90 mmHg; diastolic blood pressure of 90-99 mmHg; shock index of 0.8-1; blood oxygen saturation of 94-95%; vaginal bleeding less than menstrual flow; regular uterine contractions at a frequency of 5-10 minutes / time in primiparous women; regular uterine contractions at a frequency of 11-15 minutes / time in multiparous women; occasional vaginal discharge; increased fetal movement; pain index of 1-3; chest discomfort manifested as occasional retrosternal pain; persistent vomiting in pregnant women; gestational age ≥20 weeks with amniotic fluid index ≤5.0 on ultrasound; and gestational age ≥20 weeks with diarrhea unrelated to diet.

[0015] According to one embodiment of the present invention, the non-emergency levels requiring pre-screening and triage within 60-120 minutes include: vaginal bleeding with only traces of blood, irregular uterine contractions, no vaginal discharge, normal fetal movement, pain index of 0, and pregnant women with menstrual irregularities and vaginitis.

[0016] According to an embodiment of the present invention, step S3 specifically includes: S31. Training shall be provided to triage nurses on the contents, triage requirements and triage process included in the aforementioned triage standards. S32. Conduct assessments on trained triage nurses to select qualified triage nurses. S33. Establish a research group to formulate 20 classic cases of common emergency obstetrics and gynecology cases through literature analysis and clinical experience; S34. Select one qualified triage nurse to play the role of a patient and another qualified triage nurse to play the role of a caregiver, and complete the scenario simulation of the 20 classic cases one by one. S35. Select ten more qualified triage nurses to participate in the pre-practice operation, and triage them respectively in the scenario simulations presented in the 20 classic cases. S36. Statistically analyze the triage results of the ten qualified triage nurses in the scenario drills presented in the 20 classic cases, and compare them with the triage level setting standards. S37. The comparison results show high consistency, thus confirming the reliability of the pre-examination and triage criteria.

[0017] According to one embodiment of the present invention, there are four types of critical cases requiring immediate triage, four types of acute and severe cases requiring triage within 10 minutes, and four types of non-emergency cases requiring triage within 60-120 minutes; and eight types of emergency cases requiring triage within 30 minutes.

[0018] According to an embodiment of the present invention, step S4 specifically includes: S41. Select patient samples and divide them into a control group and an experimental group; both the control group and the experimental group patients are female, of similar age, and of the same triage level. S42. Patients in the control group were triaged and screened according to the existing emergency obstetrics and gynecology triage guidelines; patients in the experimental group were triaged and screened according to the aforementioned triage standards. S43. Statistical methods were used to analyze the triage accuracy rates of patients in the control group and patients in the experimental group. S44. Statistical results show that the triage accuracy rate of the control group was 90.25%, while that of the experimental group was 96.98%.

[0019] The beneficial effects of this invention are: After adopting the triage standards described in this application, the triage accuracy rate of triage nurses increased from 90.25% to 96.98% (P < 0.001), and the opening time of the green channel for critically ill patients was shortened from 16.89 ± 9.701 minutes to 6.55 ± 2.012 minutes (P < 0.001). This indicates that the application of this application has a significant effect on improving triage efficiency and shortening the treatment time for critically ill patients.

[0020] Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Attached Figure Description

[0021] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on the structures shown in these drawings without creative effort.

[0022] Figure 1 This is a flowchart showing the system's retrieval process for searching relevant databases on obstetrics and gynecology triage standards both domestically and internationally. Figure 2 This is a display image of the 12 selected literature articles that meet the requirements; Figure 3 This is a summary and display diagram of the evidence formed by the existing obstetrics and gynecology triage clinics; Figure 4 This is a diagram illustrating the final triage and screening standards derived from this application; Figure 5 This is a triage result display chart showing the triage results of 20 classic cases triaged by 10 pre-practice triage nurses; Figure 6 This is a statistical chart showing the Kendall's coefficient of coordination derived from 20 classic triage cases by 10 pre-practice triage nurses; Figure 7 This is a statistical chart showing the Cronbach's alpha reliability analysis between the pre-screening triage results and the standard triage results; Figure 8 This is a statistical chart showing the consistency between the pre-screening triage results and the standard triage results; Figure 9 This is a diagram showing the existing emergency obstetrics and gynecology triage standards and guidelines. Figure 10 This is a statistical table showing the basic information of patients in the control group and the experimental group. Figure 11 This is a comparison chart of the accuracy of triage results between the control group and the experimental group. Figure 12 This is a comparison chart of the opening time of the green channel for critically ill patients in the control group and the experimental group; The realization of the objective, functional features and advantages of the present invention will be further explained in conjunction with the embodiments and with reference to the accompanying drawings. Detailed Implementation

[0023] The embodiments of the present invention are described in detail below. Examples of these embodiments are shown in the accompanying drawings, wherein the same or similar reference numerals denote the same or similar elements or elements having the same or similar functions throughout. The embodiments described below with reference to the accompanying drawings are exemplary and intended to explain the present invention, and should not be construed as limiting the present invention. All other embodiments obtained by those skilled in the art based on the embodiments of the present invention without inventive effort are within the scope of protection of the present invention.

[0024] In the description of this invention, it should be understood that the terms "center," "longitudinal," "lateral," "length," "width," "thickness," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," "clockwise," "counterclockwise," "axial," "circumferential," and "radial," etc., indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings. They are only for the convenience of describing this invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be construed as limitations on this invention.

[0025] Furthermore, the terms "first" and "second" are used for descriptive purposes only and should not be construed as indicating or implying relative importance or implicitly specifying the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of this invention, "a plurality of" means two or more, unless otherwise explicitly specified.

[0026] In this invention, unless otherwise explicitly specified and limited, the terms "installation," "connection," "linking," and "fixing," etc., should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium; and they can refer to the internal connection of two components. Those skilled in the art can understand the specific meaning of the above terms in this invention according to the specific circumstances.

[0027] In this invention, unless otherwise explicitly specified and limited, "above" or "below" the second feature can include direct contact between the first and second features, or contact between the first and second features through another feature between them. Furthermore, "above," "over," and "on top" of the second feature includes the first feature directly above or diagonally above the second feature, or simply indicates that the first feature is at a higher horizontal level than the second feature. "Below," "below," and "under" the second feature includes the first feature directly below or diagonally below the second feature, or simply indicates that the first feature is at a lower horizontal level than the second feature.

[0028] The following describes in detail, with reference to the accompanying drawings, the method for constructing the emergency obstetrics and gynecology triage standard according to an embodiment of the present invention.

[0029] Reference Figures 1 to 12 As shown, the method for constructing emergency obstetrics and gynecology triage standards according to an embodiment of the present invention includes the following steps: S1. Determine the pre-examination and triage criteria, which include a single objective indicator, a single subjective indicator, and critical signs / condition indicators; The individual objective indicators include: consciousness, signs of fetal distress, amniotic fluid properties, premature rupture of membranes, respiration, blood pressure, heart rate, shock index, blood oxygen saturation, and results of tests for critical values. Furthermore, the individual subjective indicators include: neurological complaints, amount of vaginal bleeding, frequency of regular uterine contractions, amount of vaginal fluid discharge, fetal movement, pain index, and chest discomfort; The critical signs / conditions mentioned include: cardiac and respiratory arrest, airway obstruction or suffocation, umbilical cord prolapse, fetal limb prolapse outside the cervix, severe abdominal pain in pregnant women, significant discomfort or uterine contractions in pregnant women after external impact to the abdomen or waist, vaginal bleeding, abdominal pain, painless vaginal bleeding in pregnant women with prenatal diagnosis of vasa previa, regular uterine contractions in placenta accreta, ovarian cyst torsion, ectopic pregnancy and corpus luteum rupture, persistent vomiting in pregnant women, gestational age ≥20 weeks and amniotic fluid index ≤5.0 on ultrasound, gestational age ≥20 weeks and diarrhea unrelated to diet, menstrual irregularities and vaginitis; It should be noted that the aforementioned single objective indicators were derived through in-depth literature analysis, review of the textbook "Critical Care Nursing", and clinical practice summary. Our research team optimized the single objective indicator system, mainly by adding two assessment elements, shock index and amniotic fluid properties, to the existing emergency obstetrics and gynecology triage standards.

[0030] The main considerations for selecting these two assessment elements are as follows: First, this indicator is of great significance in hemodynamic monitoring, as reflected in many clinical guidelines; second, its clinical application value has been confirmed through repeated demonstrations and practical verification by the research team members; third, this indicator is easy to calculate and provides clear results, which can meet the actual work needs of frontline medical staff and facilitate rapid assessment of patient status.

[0031] Furthermore, the inclusion of amniotic fluid properties in the assessment system is primarily based on the following criteria: First, changes in amniotic fluid properties can directly reflect the fetal intrauterine status and the risk of maternal pregnancy complications; second, by observing the characteristics of amniotic fluid such as color, turbidity, and odor, potential complications such as fetal distress and intrauterine infection can be detected in a timely manner; third, this indicator is convenient to observe, making it a truly important single objective indicator for clinical risk assessment in emergency obstetrics and gynecology.

[0032] Furthermore, regarding the aforementioned individual subjective indicators, in order to systematically study the textbook "Obstetrics and Gynecology" and analyze the data of emergency obstetrics and gynecology patients, our research team expanded the individual subjective indicators. Based on summarizing clinical adverse event cases and the characteristics of patients' chief complaints, we added two individual subjective indicators: vaginal discharge volume and chest discomfort. It should be noted that the critical signs / conditions indicators mentioned above were added during the refinement process. This was achieved through in-depth study of the professional textbook "Obstetrics and Gynecology," systematic review of emergency room records, and analysis of complaint cases. The newly added critical signs / conditions indicators are as follows: ovarian cyst torsion, corpus luteum rupture, persistent vomiting in pregnant women, amniotic fluid index ≤5.0 on ultrasound at ≥20 weeks of gestation, diarrhea unrelated to diet at ≥20 weeks of gestation, menstrual irregularities, and vaginitis.

[0033] S2. The pre-examination and triage standards are classified into levels through the hospital triage system. The classification standards include the critical level (Level I) that requires immediate pre-examination and triage, the critical level (Level II) that requires pre-examination and triage within 10 minutes, the emergency level (Level III) that requires pre-examination and triage within 30 minutes, and the non-emergency level (Level IV) that requires pre-examination and triage within 60-120 minutes. It should be noted here that: For patients with unstable vital signs, their condition is at risk of rapid deterioration, requiring immediate treatment. The emergency department must allocate medical resources and equipment to provide emergency care. In this study, patients classified as Level I (critical condition) were given an immediate response timeframe by the triage nurses.

[0034] For patients with severe conditions, their symptoms may rapidly deteriorate to a life-threatening level within a short period, requiring priority medical treatment and appropriate healthcare measures. In this study, patients classified as acute and severe (Level II) had a response time of within 10 minutes for triage nurses.

[0035] For emergency patients who do not pose an immediate risk of life-threatening danger or significant functional impairment, the medical team can appropriately arrange their medical process within a specific time frame. In this study, patients classified as emergency level (Level III) had a response time limit of 30 minutes for triage nurses.

[0036] Patients whose current condition is stable, who do not exhibit acute symptoms, and who have no obvious discomfort or only mild symptoms are classified as non-emergency level (Level IV) in this study. The response time for triage nurses is 60-120 minutes.

[0037] S3. Conduct a preliminary trial of the triage criteria that have been graded to assess their reliability; Steps S1 and S2 are analyses and theoretical summaries based on various data. Therefore, when applying them clinically, they need to be tested in practice, i.e., step S3, to evaluate the reliability of the triage criteria described in this application.

[0038] When assessing the reliability of the pre-screening and triage criteria described in this application, step S4 can be performed, namely: S4. Verify the pre-testing and triage standards that have been tested in practice, that is, conduct clinical practice to verify their ultimate scientific validity and feasibility.

[0039] Based on the above, it is clear that in its specific implementation, this application mainly discloses a method for constructing pre-examination and triage standards for emergency obstetrics and gynecology departments.

[0040] Specifically, when applying this application, the pre-examination and triage standards described herein have been pre-tested and their reliability has been fully determined. In clinical application, their scientific validity and feasibility have also been verified. As a result, the construction of this application can significantly improve the triage accuracy of emergency obstetrics and gynecology triage nurses in clinical application, and can effectively shorten the opening time of the green channel for critically ill patients in emergency obstetrics and gynecology, which is of great significance for improving the quality of pre-examination and triage in emergency obstetrics and gynecology.

[0041] Furthermore, in a specific implementation according to an embodiment of the present invention, step S1 specifically includes: S11. Determine the inclusion and exclusion criteria for the literature, systematically search relevant databases of obstetrics and gynecology triage standards at home and abroad, and screen literature that meets the requirements; Specifically, according to one embodiment of the present invention, in step S11, The inclusion criteria for the literature were as follows: the study type was original research, clinical research, observational research, and guidelines related to emergency obstetrics and gynecology triage; the study subjects were obstetrics and gynecology emergency patients, including pregnant women and gynecological emergency patients; the interventions were measures related to triage, including triage standards and emergency procedures; and the outcome indicators were triage accuracy, waiting time, patient satisfaction, and clinical outcomes. The exclusion criteria for literature are: duplicate publications, literature of low research quality, literature with incomplete data, and literature unrelated to the research topic.

[0042] Through step S11, a total of 1851 articles were retrieved (1248 from CNKI, 104 from Wanfang Medical Database, 4 from China Biomedical Literature Database, 308 from PubMed, and 187 from Webofscience). After filtering the articles by removing duplicates and reviewing their titles and abstracts, 12 articles that met the requirements were included.

[0043] The detailed search flowchart is attached to this application specification. Figure 1 As shown; the selected literature is listed in the appendix to this application specification. Figure 2 .

[0044] S12. Conduct methodological quality evaluation on the selected literature that meets the requirements, assess the rationality and scientificity of the research design, extract key research data and results through the design of standardized data extraction tables, organize and statistically analyze the data, and form a summary of evidence. The resulting summary diagram of evidence is shown in the appendix to this application. Figure 3 As shown.

[0045] S13. Establish an expert inquiry group and use the Delphi expert inquiry method to conduct an inquiry questionnaire survey on the collected evidence through experts. In step S13, the interpretation of the Delphi expert consultation method can be understood as follows: the size, academic influence, and field distribution of the expert consultation team are the core elements constituting the Delphi method, and are of great significance in reducing research bias. Based on systematic literature review, evidence-based practice, and team discussions, a preliminary triage plan for emergency obstetrics and gynecology departments is formulated.

[0046] The specific procedures are as follows: Expert suggestions are collected through anonymous inquiries; the feedback is analyzed and integrated to create a revised questionnaire, and expert opinions are solicited again. This process is repeated until a consensus is reached. Throughout the consultation process, the principle of expert confidentiality is strictly adhered to, avoiding mutual interference and ensuring that each expert thinks independently and provides objective and credible professional judgment.

[0047] Furthermore, the actual operation process of step S13 is as follows: S131. Establish an expert consultation group; Following the sample size setting principles for expert opinion consultation and in accordance with the research objectives, this study selected 16 experts from 8 district-level maternal and child health hospitals (maternal and child specialty hospitals) in Shenzhen. Inclusion criteria: ① Maternal and child specialty hospitals; ② Clinical nursing experts in emergency obstetrics and gynecology triage or obstetrics and gynecology wards; ③ Holding a senior nurse title or above; ④ Holding a bachelor's degree or above; ⑤ Having 10 years or more of work experience in their professional field; ⑥ Willing to participate in this research project, able to actively provide comprehensive and guiding opinions and suggestions, and able to complete two rounds of consultations. Exclusion criteria: ① Unwilling to participate in this research project; ② Withdrawing midway.

[0048] S132. Compile expert inquiry questionnaires; Based on the initial draft of the pre-examination and triage standards for the emergency obstetrics and gynecology departments of maternal and child health hospitals, the research team developed an expert inquiry form, which includes three parts: (1) Explain the application goals and practical value of the inquiry form in the research, as well as the guiding significance of expert suggestions for the research.

[0049] (2) Instructions for filling out the form, basic information collection form for experts, and the basis for experts' judgment on the content of the inquiry and their level of familiarity with it. The basis for experts' judgment on the content of the inquiry includes practical experience, theoretical analysis, references, and intuitive selection; the familiarity with the content of the inquiry is divided into three aspects: familiarity with the content of the inquiry, familiarity with the requirements of emergency obstetrics and gynecology triage, and familiarity with the process of emergency obstetrics and gynecology triage. The level of familiarity is as follows: very familiar, familiar, average, not very familiar, and unfamiliar.

[0050] (3) The content of the consultation letter for the pre-examination and triage standards of the emergency obstetrics and gynecology department of the maternal and child specialist hospital: expert consultation form for single objective indicators, including expert consultation on the types, importance and classification of single objective indicators; expert consultation form for single subjective indicators, including expert consultation on the types, importance and classification of single subjective indicators; expert consultation form for critical signs / conditions and other indicators, including expert consultation on the types, importance and classification of critical signs / conditions and other indicators.

[0051] Both rounds of expert consultations were conducted via email. The results of both rounds of consultations were then compiled and analyzed. Items were then added to, deleted from, or modified. The second round of expert opinions reached a consensus, and the consultation process concluded.

[0052] S14. Analyze and summarize the results of the questionnaire survey to derive the final pre-examination and triage criteria.

[0053] The final triage criteria derived are as shown in the appendix to this application. Figure 4 As shown.

[0054] In the appendix Figure 4 According to one embodiment of the present invention, the critical level (Level I) requiring immediate pre-screening and triage includes: sudden loss of consciousness or alteration of its severity in the pregnant woman (convulsions, drowsiness, syncope, disorientation, stupor, coma, etc.); signs of fetal distress manifested as a fetal heart rate consistently ≥160 bpm or ≤110 bpm or an electronic fetal heart rate monitoring assessment of Category III; amniotic fluid characteristics manifested as bloody amniotic fluid, yellow-green turbid amniotic fluid, thick amniotic fluid, or brownish-yellow amniotic fluid; premature rupture of membranes manifested as premature rupture of membranes in breech, transverse, or other abnormal fetal positions; respiratory rate ≥30 breaths / min or ≤9 breaths / min; systolic blood pressure ≥160 mmHg or ≤75 mmHg; diastolic blood pressure ≥110 mmHg; heart rate ≥130 bpm or ≤40 bpm; shock index (heart rate / systolic blood pressure) >1.5; oxygen saturation ≤91% or pallor or cyanosis; and carrying critical values. Examination results, neurological complaints include headache, blurred vision or dizziness, vaginal bleeding heavier than menstrual flow, regular uterine contractions ≤2 minutes / time in primiparous women with involuntary abdominal pressure, regular uterine contractions 3-4 minutes / time in multiparous women with involuntary abdominal pressure, excessive vaginal discharge, loss of fetal movement, pain index of 7-10, chest discomfort manifested as persistent retrosternal pain, cardiac and respiratory arrest, airway obstruction or suffocation, umbilical cord prolapse, fetal limb prolapse outside the cervix, severe abdominal pain in pregnant women (suspected uterine rupture / threatened uterine rupture / placental abruption / suspected surgical acute abdomen, such as pancreatitis, etc.), significant discomfort or accompanied by uterine contractions, vaginal bleeding, abdominal pain after external impact to the abdomen or waist in pregnant women, painless vaginal bleeding in pregnant women with confirmed vasa previa during prenatal examination, regular uterine contractions due to placenta accreta, ovarian cyst torsion, ectopic pregnancy, and ruptured corpus luteum.

[0055] In the appendix Figure 4 According to one embodiment of the present invention, the acute and severe illness level (Level II) requiring pre-screening and triage within 10 minutes includes: fetal distress signs assessed as Category II by electronic fetal heart rate monitoring; amniotic fluid characteristics as light green; premature rupture of membranes in twins; pregnant women ≤32 weeks of gestation with significant vaginal discharge and normal fetal heart rate; respiratory rate of 21-29 breaths / min; systolic blood pressure of 140-159 mmHg or 76-80 mmHg; and diastolic blood pressure of 100-100 mmHg. 9 mmHg, heart rate 110-129 beats / min or 41-49 beats / min, shock index 1 < 1.5, blood oxygen saturation 92-93%, vaginal bleeding equal to menstrual flow, regular uterine contraction frequency of 3-4 minutes / time for primiparous women, regular uterine contraction frequency of 5-10 minutes / time for multiparous women, little vaginal discharge, perceived decrease in fetal movement, pain index 4-6, chest discomfort manifested as intermittent retrosternal pain, scar pregnancy, ovarian stimulation syndrome, out-of-hospital delivery without treatment.

[0056] In the appendix Figure 4 According to one embodiment of the present invention, the emergency level (Level III) requiring pre-screening and triage within 30 minutes includes: fetal distress signs as assessed as Class I by electronic fetal heart rate monitoring; premature rupture of membranes as vaginal discharge and normal fetal heart rate in pregnant women with gestational age >32 weeks; systolic blood pressure of 81-90 mmHg; diastolic blood pressure of 90-99 mmHg; shock index of 0.8-1; blood oxygen saturation of 94-95%; vaginal bleeding less than menstrual flow; regular uterine contractions at a frequency of 5-10 minutes / time in primiparous women; regular uterine contractions at a frequency of 11-15 minutes / time in multiparous women; occasional vaginal discharge; increased fetal movement; pain index of 1-3; chest discomfort as occasional retrosternal pain; persistent vomiting in pregnant women; gestational age ≥20 weeks with amniotic fluid index ≤5.0 on ultrasound; and gestational age ≥20 weeks with diarrhea unrelated to diet.

[0057] In the appendix Figure 4 According to one embodiment of the present invention, the non-emergency level (Level IV) requiring pre-examination and triage within 60-120 minutes includes: vaginal bleeding of small amount with only blood streaks, irregular uterine contractions, no vaginal discharge, normal fetal movement, pain index of 0, and pregnant women with menstrual disorders and vaginitis.

[0058] Furthermore, in a specific implementation according to an embodiment of the present invention, step S3 specifically includes: S31. Training shall be provided to triage nurses on the contents, triage requirements and triage procedures included in the aforementioned triage standards. It should be noted that the inclusion criteria for the training participants were: nurses with a registered nurse title or above and a college diploma or above, who had at least two years of experience in the pre-screening and triage work of the emergency obstetrics and gynecology department of a maternal and child health hospital. Exclusion criteria included: personnel who were on maternity leave, breastfeeding leave, or sick leave exceeding one month during the study period, or those who rotated to other departments during the study. Ultimately, 50 emergency department pre-screening and triage nurses were included as training participants in this study.

[0059] The training content mainly includes: (1) The training content of the 50 triage nurses included in this study: the complete content of the triage standard of the emergency obstetrics and gynecology department of the maternal and child health hospital: including all the indicators, on-site guidance of clinical implementation, feedback on problems in the implementation process, etc. The training content remained unchanged each time to achieve homogeneous training.

[0060] (2) Training of participants: Training content for emergency nurses playing patients: requirements and procedures for triage in emergency obstetrics and gynecology; detailed content, triage categories, and triage levels of 20 common classic cases; full content and clinical implementation process of the pre-examination and triage standards for emergency obstetrics and gynecology in maternal and child health hospitals.

[0061] S32. Conduct assessments on trained triage nurses to select qualified triage nurses. At the end of the training, an assessment of the pre-examination and triage standards was conducted using a paper-based test. All 50 nurses who took the test scored ≥95 points to pass.

[0062] S33. Establish a research group to formulate 20 classic cases of common emergency obstetrics and gynecology cases through literature analysis and clinical experience; Preferably, in this technical solution, according to an embodiment of the present invention, the number of critically ill (Level I) cases requiring immediate triage, the number of acute and severe (Level II) cases requiring triage within 10 minutes, and the number of non-emergency (Level IV) cases requiring triage within 60-120 minutes are all set to 4, and the number of emergency (Level III) cases requiring triage within 30 minutes is set to 8.

[0063] The 20 classic cases are as follows: (1) A 32-year-old female patient, gestational age 38 weeks + 3 days, para 0, with no abnormalities found during routine prenatal checkups, presented to the emergency obstetrics and gynecology triage desk with "vaginal discharge for 30 minutes". The nurse auscultated the fetal heart rate at 145 beats / min and found bloody amniotic fluid. She did not complain of any other discomfort. What is the triage level for this patient, and how long should treatment be initiated? (Critical level: Immediate) (2) A 30-year-old female patient, gestational age 39 weeks + 1 day, para 2, routine prenatal checkup showed breech presentation. She presented to the emergency obstetrics and gynecology triage desk with "vaginal discharge for 30 minutes." The nurse auscultated the fetal heart rate at 158 ​​beats / min, and the amniotic fluid was clear. She did not complain of any other discomfort. What is the triage level for this patient, and how long should treatment be initiated? (Critical level: Immediate) (3) Patient, female, 32 years old, 45 days of amenorrhea, blood pressure: 75 / 43 mmHg, pulse: 80 beats / min, routine physical examination showed normal blood pressure, no other discomfort reported. What level of triage is this patient, and how long should treatment be initiated (critical level: immediate); (4) A 34-year-old female patient, gestational age 38 weeks + 2 days (pregnancy 2 para 1), experienced occasional irregular contractions and had not had regular prenatal checkups. She brought the results of an electronic fetal heart rate monitoring system (sine wave) from another hospital to the triage desk of the emergency obstetrics and gynecology department. The nurse's examination revealed: blood pressure 116 / 75 mmHg, pulse 62 bpm, fetal heart rate 158 bpm, and no other discomfort reported. What is the triage level for this patient, and how long should treatment be initiated? (Critical level: Immediate) (5) A 32-year-old female patient, gestation 1 para 0, 31 weeks + 3 days pregnant, with no abnormalities found during routine prenatal checkups, presented to the emergency obstetrics and gynecology triage desk with "vaginal discharge for 30 minutes". The nurse auscultated the fetal heart rate at 158 ​​beats / min, and the amniotic fluid was clear. She did not complain of any other discomfort. What level of triage is this patient, and how long should treatment take? (Emergency level: within 10 minutes) (6) A 32-year-old female patient, 45 days postmenopausal, with a blood pressure of 80 / 55 mmHg and a pulse of 120 beats / min. Routine physical examination revealed normal blood pressure. She reported no other discomfort. What triage level should this patient be in, and how long should treatment take? (Acute / Critical level: within 10 minutes) (7) Patient, female, 34 years old, gestation 2 para 1, 38 weeks + 2 days, regular prenatal check-up, nurse physical examination: blood pressure: 116 / 75 mmHg, pulse: 62 beats / min, fetal heart sounds 148 beats / min, complains of regular abdominal pain 5-10 minutes / time, what level is this patient triaged, how long should treatment take (emergency level: within 10 minutes); (8) A 32-year-old female patient, gestational age 38 weeks + 2 days, with no abnormalities found during routine prenatal checkups, complained of lower back pain for 1 hour. She arrived at the triage desk of the emergency obstetrics and gynecology department. The nurse's examination revealed: blood pressure 116 / 75 mmHg, pulse 62 bpm, fetal heart rate 148 bpm, and pain index 4-6. What is the triage level for this patient, and how long should treatment take? (Emergency / critical level: within 10 minutes) (9) A 31-year-old female patient, gestational age 10 weeks + 2 days, para 0, presented with persistent vomiting. Her blood pressure was 116 / 75 mmHg and her pulse was 62 beats / min. She reported no other discomfort. What triage level should this patient be in, and how long should treatment take? (Emergency level: within 30 minutes) (10) Patient, female, 32 years old, gestational age 32 weeks + 2 days, gravida 1 para 0, routine prenatal check-up showed no abnormalities. Prenatal ultrasound results showed: amniotic fluid index 4.8, blood pressure: 116 / 75 mmHg, pulse: 78 beats / min, fetal heart rate 148 beats / min, no other discomfort reported. What level of triage is this patient, and how long should treatment take (emergency level: within 30 minutes)? (11) A 32-year-old female patient, gestational age 30 weeks + 2 days, with normal routine prenatal check-ups, suddenly developed diarrhea. She had no history of food poisoning. Her blood pressure was 116 / 75 mmHg, pulse was 78 beats / min, and fetal heart rate was 148 beats / min. She did not complain of any other discomfort. What level of triage is this patient, and how long should treatment take? (Emergency level: within 30 minutes) (12) A 32-year-old female patient, gestational age 38 weeks + 2 days, para 0, with no abnormalities found in routine prenatal checkups, complained of occasional retrosternal pain and went to the triage desk of the emergency obstetrics and gynecology department. The nurse's physical examination revealed: blood pressure: 116 / 75 mmHg, pulse: 62 beats / min, fetal heart rate of 148 beats / min, and pain index: 1-3. What is the triage level for this patient, and how long should the treatment take? (Emergency level: within 30 minutes) (13) A 32-year-old female patient, gestational age 38 weeks + 2 days, para 0, with no abnormalities found during routine prenatal checkups, complained of increased fetal movement and went to the triage desk of the emergency obstetrics and gynecology department. The nurse's examination revealed: blood pressure: 116 / 75 mmHg, pulse: 62 beats / min, fetal heart rate of 148 beats / min, and no other discomfort reported. What is the triage level for this patient, and how long should the treatment take? (Emergency level: within 30 minutes) (14) A 32-year-old female patient, gestational age 38 weeks + 2 days, para 0, with no abnormalities found in routine prenatal checkups, complained of occasional vaginal discharge and went to the triage desk of the emergency obstetrics and gynecology department. The nurse's examination revealed: blood pressure 116 / 75 mmHg, pulse 62 bpm, fetal heart rate 148 bpm, and no other discomfort reported. What is the triage level for this patient, and how long should treatment take? (Emergency level: within 30 minutes) (15) Patient, female, 34 years old, gestation 2 para 1, 38 weeks + 2 days, regular prenatal check-up, nurse physical examination: blood pressure: 116 / 75 mmHg, pulse: 62 beats / min, fetal heart sounds 148 beats / min, complains of regular abdominal pain 11-15 minutes / time, what level is this patient triaged, how long should treatment take (emergency level: within 30 minutes); (16) A 32-year-old female patient, with 45 days of amenorrhea, had a blood pressure of 95 / 60 mmHg and a pulse of 80 beats / min. She complained of vaginal bleeding, but the amount of bleeding was less than the heaviest amount during her menstrual period. She did not complain of any other discomfort. What level of triage is this patient, and how long should treatment take? (Emergency level: within 30 minutes) (17) A 32-year-old female patient, with amenorrhea for 45 days, had a blood pressure of 95 / 60 mmHg and a pulse of 80 beats / min. She complained of vaginal bleeding, which was a small amount of blood streaks. She did not complain of any other discomfort. What level of triage should this patient be classified into, and how long should treatment take? (Non-emergency level: 60-120 minutes) (18) Patient, female, 34 years old, gestation 2 para 1, 38 weeks + 2 days, regular prenatal check-up, nurse physical examination: blood pressure: 116 / 75 mmHg, pulse: 62 beats / min, fetal heart sounds 148 beats / min, complains of irregular abdominal pain. What level is this patient triaged, and how long should treatment take (non-emergency level: 60-120 minutes); (19) Patient, female, 32 years old, blood pressure: 106 / 63 mmHg, pulse: 90 beats / min, complains of vulvar itching and cottage cheese-like vaginal discharge. What level of triage is this patient, and how long should treatment take (non-emergency level: 60-120 minutes); (20) Patient, female, 30 years old, blood pressure: 112 / 65 mmHg, pulse: 68 beats / min, amenorrhea for 50 days, urine pregnancy test negative, complains of irregular menstruation, cycle 28-60 days. What level is this patient triaged, and how long should treatment be given (non-emergency level: 60-120 minutes).

[0064] S34. Select one qualified triage nurse to play the role of a patient and another qualified triage nurse to play the role of a caregiver, and complete the scenario simulation of the 20 classic cases one by one. S35. Select ten more qualified triage nurses to participate in the pre-practice operation, and triage them respectively in the scenario simulations presented in the 20 classic cases. S36. Statistically analyze the triage results of the ten qualified triage nurses in the scenario drills presented in the 20 classic cases, and compare them with the triage level setting standards. Results of 10 pre-trial triage nurses triaging 20 classic cases: 28 cases were accurately triaged to the endangered level (Level I); 9 cases were incorrectly classified as critical illness level (Level II) to the endangered level (Level I); and 3 cases were incorrectly classified as emergency level (Level III) to the endangered level (Level I).

[0065] The number of cases correctly triaged to the acute and severe illness level (Level II) was 26; 8 cases were incorrectly classified as critically ill (Level I) due to the acute and severe illness level (Level II); and 6 cases were incorrectly classified as acute (Level III) due to the acute and severe illness level (Level II).

[0066] The number of cases correctly triaged to the acute level (Level III) was 64; 1 case was incorrectly classified as critical level (Level I) to the acute level (Level III); 13 cases were incorrectly classified as acute and severe level (Level II) to the acute level (Level III); and 2 cases were incorrectly classified as non-acute level (Level IV) to the acute level (Level III).

[0067] The accurate number of cases triaged under the non-emergency level (Level IV) was 40.

[0068] Specific triage results are as shown in the appendix to this application. Figure 5 As shown.

[0069] S37. The comparison results show high consistency, thus confirming the reliability of the pre-examination and triage criteria.

[0070] (1) The consistency of the pre-examination and triage of 20 scenario simulation cases among 10 nurses was compared. The results showed that it was statistically significant (P<0.001). The Kendall coefficient of harmony was 0.727, indicating that the scoring criteria among the 10 nurses were relatively consistent.

[0071] The specific Kendall's coefficient of coordination statistics are shown in the appendix to this application. Figure 6 As shown.

[0072] (2) The Cronbach's alpha coefficient between the nurses' pre-examination triage results and the standard triage results was 0.713, the unweighted Kappa value was 0.711 (95% CI 0.634-0.788), the linearly weighted Kappa value was 0.795 (95% CI 0.735-0.855), and the quadratic weighted Kappa value was 0.870 (95% CI 0.822-0.917), indicating that the pre-examination triage results of the 10 nurses were relatively consistent with the standard triage results.

[0073] The specific Cronbach's alpha reliability analysis statistics are shown in the appendix to this application. Figure 7 As shown in the attached table; a statistical table showing the consistency between nurses' pre-screening and triage results and standard triage results, as per this application specification. Figure 8 As shown.

[0074] Therefore, this preliminary practice, through statistical analysis of 10 emergency obstetrics and gynecology triage nurses, assessed individual objective indicators, individual subjective indicators, critical signs / conditions indicators, and other indicators of 20 classic cases to complete the triage process. By measuring the consistency among triage nurses and the consistency between the triage results and the standard triage results, the analysis concludes that the triage criteria described in this application have high reliability.

[0075] Furthermore, in a specific implementation according to an embodiment of the present invention, step S4 specifically includes: S41. Select patient samples and set up a control group and an experimental group. The patients in the control group and the experimental group were all female, of similar age, and at the same triage level. Each group had 728 patients, for a total of 1456 patients, which was a very sufficient sample size.

[0076] S42. Patients in the control group were triaged and screened according to the existing emergency obstetrics and gynecology triage guidelines; patients in the experimental group were triaged and screened according to the aforementioned triage standards. Specifically, the control group consisted of emergency obstetrics and gynecology triage nurses who triaged emergency obstetrics and gynecology patients from January 1 to March 31, 2024, using the department's existing emergency obstetrics and gynecology triage standard guidelines. The experimental group consisted of emergency obstetrics and gynecology triage nurses who triaged emergency obstetrics and gynecology patients from May 15 to August 15, 2024, using the triage standards described in this application.

[0077] Among them, the existing emergency obstetrics and gynecology triage standard guidelines are attached to this application. Figure 9 As shown; S43. Statistical methods were used to analyze the triage accuracy rates of patients in the control group and patients in the experimental group.

[0078] The basic information statistics of patients in the control group and the experimental group are attached to this application specification. Figure 10 As shown.

[0079] S44. Statistical results show that the triage accuracy rate of the control group was 90.25%, while that of the experimental group was 96.98%.

[0080] A detailed comparison table of triage result accuracy is attached to this application. Figure 11 As shown.

[0081] Furthermore, before the implementation of the pre-examination and triage standards for the emergency obstetrics and gynecology department of the maternal and child health hospital, the opening time (in minutes) for the green channel for critically ill patients was 16.89±9.701 minutes; after the implementation of the standards, the opening time (in minutes) for the green channel for critically ill patients was 6.55±2.012 minutes. The reduction in the opening time (in minutes) of the green channel for critically ill patients after the implementation of the pre-examination and triage standards for the emergency obstetrics and gynecology department of the maternal and child health hospital compared to before the implementation of the standards was statistically significant (P<0.05). The comparison chart showing the time limit for the green channel for critically ill patients in the control group and the experimental group is attached to this application. Figure 12 As shown.

[0082] Therefore, it is evident that by adopting the triage standards described in this application, the triage accuracy rate of triage nurses can be increased from 90.25% to 96.98% (P < 0.001), and the opening time of the green channel for critically ill patients can be shortened from 16.89 ± 9.701 minutes to 6.55 ± 2.012 minutes (P < 0.001). This demonstrates that the application of this application has a significant effect on improving triage efficiency and shortening the treatment time for critically ill patients.

[0083] Other embodiments, etc., will not be described here.

[0084] In summary, the method for constructing emergency obstetrics and gynecology triage standards provided in this application, in practical implementation, firstly, integrates a four-dimensional evaluation system comprising single objective indicators, single subjective indicators, critical signs / condition indicators, and other indicators, providing triage nurses with a more comprehensive and accurate decision-making basis, effectively improving triage accuracy. Secondly, this study utilizes the Delphi expert consultation method combined with clinical practice validation, ensuring the scientific validity and operability of the triage standards, responding to the requirements of the newly released "Emergency Medicine Quality Control Indicators (2024 Edition)" regarding "standardizing the emergency triage process," and effectively improving emergency treatment efficiency by shortening the green channel opening time for critically ill patients. Furthermore, the 20 typical case studies established in this study provide standardized teaching resources for triage nurse training, helping to improve the professional competence of triage personnel.

[0085] Furthermore, the method for constructing emergency obstetrics and gynecology triage standards provided in this application is indeed highly practical and has excellent results, which makes this application inherently valuable for market promotion and will certainly be very popular and effectively popularized.

[0086] In the description of this specification, the references to terms such as "one embodiment," "some embodiments," "example," "specific example," or "some examples," etc., refer to specific features, structures, materials, or characteristics described in connection with that embodiment or example, which are included in at least one embodiment or example of the present invention. In this specification, the illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in one or more embodiments or examples. Moreover, without contradiction, those skilled in the art can combine and integrate the different embodiments or examples described in this specification, as well as the features of different embodiments or examples.

[0087] The above description is merely a preferred embodiment of the present invention and does not limit the patent scope of the present invention. Any equivalent structural transformations made using the contents of the present invention's specification and drawings under the inventive concept of the present invention, or direct / indirect applications in other related technical fields, are included within the patent protection scope of the present invention.

Claims

1. A method for constructing triage standards in emergency obstetrics and gynecology departments, characterized in that, Includes the following steps: S1. Determine the triage criteria, which include individual objective indicators, individual subjective indicators, and critical signs / conditions; Individual objective indicators include: consciousness, signs of fetal distress, amniotic fluid characteristics, premature rupture of membranes, respiration, blood pressure, heart rate, shock index, blood oxygen saturation, and results of tests carrying critical values. Individual subjective indicators include: neurological complaints, amount of vaginal bleeding, frequency of regular uterine contractions, amount of vaginal fluid discharge, fetal movement, pain index, and chest discomfort; Critical signs / condition indicators include: cardiac and respiratory arrest, airway obstruction or suffocation, umbilical cord prolapse, fetal limb prolapse outside the cervix, severe abdominal pain in pregnant women, significant discomfort or uterine contractions in pregnant women after external impact to the abdomen or waist, vaginal bleeding, abdominal pain, painless vaginal bleeding in pregnant women with prenatal diagnosis of vasa previa, regular uterine contractions in placenta accreta, ovarian cyst torsion, ectopic pregnancy and corpus luteum rupture, persistent vomiting in pregnant women, gestational age ≥20 weeks and amniotic fluid index ≤5.0 on ultrasound, gestational age ≥20 weeks and diarrhea unrelated to diet, menstrual irregularities and vaginitis; S2. The pre-examination and triage standards are classified into levels through the hospital triage system. The classification standards include the critical level that requires immediate pre-examination and triage, the critical level that requires pre-examination and triage within 10 minutes, the emergency level that requires pre-examination and triage within 30 minutes, and the non-emergency level that requires pre-examination and triage within 60-120 minutes. S3. Conduct a trial run of the graded triage criteria to assess its reliability; S4. Validate the pre-tested triage standards.

2. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, Step S1 specifically includes: S11. Determine the inclusion and exclusion criteria for the literature, systematically search relevant databases of obstetrics and gynecology triage standards at home and abroad, and screen literature that meets the requirements; S12. Conduct methodological quality evaluation on the selected literature that meets the requirements, assess the rationality and scientificity of the research design, extract key research data and results through the design of standardized data extraction tables, organize and statistically analyze the data, and form a summary of evidence. S13. Establish an expert inquiry group and use the Delphi expert inquiry method to conduct an inquiry questionnaire survey on the collected evidence through experts. S14. Analyze and summarize the results of the questionnaire survey to derive the final pre-examination and triage criteria.

3. The method for constructing emergency obstetrics and gynecology triage standards according to claim 2, characterized in that, In step S11, Inclusion criteria: The study type was original research, clinical research, observational research, and guidelines related to emergency obstetrics and gynecology triage; the study subjects were obstetrics and gynecology emergency patients, including pregnant women and gynecological emergency patients; the interventions were measures related to triage, including triage standards and emergency procedures; the outcome measures were triage accuracy, waiting time, patient satisfaction, and clinical outcomes. Literature exclusion criteria: duplicate publications, literature of low research quality, literature with incomplete data, and literature unrelated to the research topic.

4. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, The critical levels requiring immediate triage include: sudden loss of consciousness or alteration in the degree of consciousness in the pregnant woman; signs of fetal distress such as a fetal heart rate consistently ≥160 bpm or ≤110 bpm or classified as Category III by electronic fetal heart rate monitoring; amniotic fluid characteristics such as bloody amniotic fluid, yellowish-green turbid amniotic fluid, thick amniotic fluid, or brownish-yellow amniotic fluid; premature rupture of membranes (PROM) in breech, transverse, or other abnormal fetal positions; respiratory rate ≥30 breaths / min or ≤9 breaths / min; systolic blood pressure ≥160 mmHg or ≤75 mmHg; diastolic blood pressure ≥110 mmHg; heart rate ≥130 bpm or ≤40 bpm; shock index >1.5; oxygen saturation ≤91% or pallor or cyanosis; presence of critical test results; and neurological disorders. The chief complaints include headache, blurred vision or dizziness, vaginal bleeding heavier than menstrual flow, regular uterine contractions ≤2 minutes / time in primiparous women with involuntary abdominal pressure, regular uterine contractions 3-4 minutes / time in multiparous women with involuntary abdominal pressure, large amount of vaginal discharge, loss of fetal movement, pain index of 7-10, chest discomfort manifested as persistent retrosternal pain, cardiac and respiratory arrest, airway obstruction or suffocation, umbilical cord prolapse, fetal limb prolapse outside the cervix, severe abdominal pain in pregnant women, significant discomfort or accompanied by uterine contractions after external impact to the abdomen or waist in pregnant women, vaginal bleeding, abdominal pain, painless vaginal bleeding in pregnant women with vasa previa confirmed by prenatal examination, regular uterine contractions due to placenta accreta, ovarian cyst torsion, ectopic pregnancy, and ruptured corpus luteum.

5. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, The following are the acute and critical illness levels requiring triage within 10 minutes: fetal distress signs assessed as Category II by electronic fetal heart rate monitoring; amniotic fluid appearing light green; premature rupture of membranes in twins; pregnant women ≤32 weeks gestation with significant vaginal discharge and normal fetal heart rate; respiratory rate of 21-29 breaths / min; systolic blood pressure of 140-159 mmHg or 76-80 mmHg; diastolic blood pressure of 100-109 mmHg; and heart rate of 1... 10-129 beats / min or 41-49 beats / min, 1 < shock index ≤ 1.5, blood oxygen saturation 92-93%, vaginal bleeding equal to menstrual flow, regular uterine contraction frequency of 3-4 min / time for primiparous women, regular uterine contraction frequency of 5-10 min / time for multiparous women, little vaginal discharge, perceived decrease in fetal movement, pain index 4-6, chest discomfort manifested as intermittent retrosternal pain, scar pregnancy, ovarian stimulation syndrome, out-of-hospital delivery without treatment.

6. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, Emergency levels requiring triage within 30 minutes include: fetal distress signs assessed as Category 1 by electronic fetal heart rate monitoring; premature rupture of membranes (PROM) in pregnant women >32 weeks of gestation with vaginal discharge and normal fetal heart rate; systolic blood pressure of 81-90 mmHg, diastolic blood pressure of 90-99 mmHg, shock index of 0.8-1, oxygen saturation of 94-95%; vaginal bleeding less than menstrual flow; regular uterine contractions in primiparous women at a frequency of 5-10 minutes / time; regular uterine contractions in multiparous women at a frequency of 11-15 minutes / time; occasional vaginal discharge; increased fetal movement; pain index of 1-3; chest discomfort manifested as occasional retrosternal pain; persistent vomiting in pregnant women; gestational age ≥20 weeks with amniotic fluid index ≤5.0 on ultrasound; and gestational age ≥20 weeks with diarrhea unrelated to diet.

7. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, Non-emergency categories requiring triage within 60-120 minutes include: light vaginal bleeding with only blood streaks, irregular uterine contractions, no vaginal discharge, normal fetal movement, pain index of 0, and pregnant women with menstrual irregularities and vaginitis.

8. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, Step S3 specifically includes: S31. Provide training to triage nurses on the content, requirements and procedures of the pre-examination triage standards. S32. Conduct assessments on trained triage nurses to select qualified triage nurses. S33. Establish a research group to formulate 20 classic cases of common emergency obstetrics and gynecology cases through literature analysis and clinical experience; S34. Select one qualified triage nurse to play the role of a patient and another qualified triage nurse to play the role of a caregiver, and complete the scenario simulation of 20 classic cases one by one. S35. Select ten more qualified triage nurses to participate in the pre-practice operation, and conduct triage according to the scenarios presented in 20 classic cases. S36. Compile the triage results of ten qualified triage nurses in the scenario drills presented in 20 classic cases, and compare them with the triage level standards.

9. The method for constructing emergency obstetrics and gynecology triage standards according to claim 8, characterized in that, Four cases are designated for triage: critical cases requiring immediate triage, critical cases requiring triage within 10 minutes, and non-critical cases requiring triage within 60-120 minutes. Eight cases are designated for triage within 30 minutes.

10. The method for constructing emergency obstetrics and gynecology triage standards according to claim 1, characterized in that, Step S4 specifically includes: S41. Select patient samples and divide them into a control group and an experimental group; both the control group and the experimental group patients are female, of similar age, and of the same triage level. S42. Patients in the control group were triaged and screened according to the existing emergency obstetrics and gynecology triage standards and guidelines; patients in the experimental group were triaged and screened according to the existing triage standards. S43. Statistical methods were used to analyze the triage accuracy rates of patients in the control group and patients in the experimental group.

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