新生儿重症监护室应用集束化管理预防患儿非计划拔管临床效果观察  

Clinical effect of cluster intervention management in prevention of unplanned extubation of neonates in NICU

作　　者：何婧[1] 罗碧如[1] 张勇[2] 刘蓓蓓[2] 罗敏[2] 何敏[2] 王雪芹[2] 

机构地区：[1]四川大学华西第二医院,四川成都610041 [2]四川省妇幼保健院新生儿科,四川成都610045

出　　处：《实用医院临床杂志》2016年第6期125-127,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨集束化管理在预防新生儿重症监护室(NICU)患儿非计划拔管的效果。方法选择2015年3月1日至2016年2月28日入住我院NICU置管的患儿765例为试验组,采用集束化管理措施包括:充分循证,制定预防非计划拔管的集束化管理策略,运用3 T安抚镇静,使用安全护理评估表评估管道危险因素,改进人力资源管理模式等,培训所有护士,经考核合格后参与实施集束化护理。2014年1月1日至2015年12月31日置管的患儿598例为对照组,采用各种管道常规护理方法。比较两组患儿非计划拔管发生率。结果试验组置管共1167例次,非计划拔管发生66例次(5.66%);对照组置管共940例次,非计划拔管发生164例次(17.45%),两组非计划拔管率比较,差异有显著性意义(χ2=75.65,P<0.01)。结论实施集束化管理可有效预防NICU患儿非计划拔管率,保证了患儿治疗效果和安全。Objective To explore the effect of the cluster intervention management in prevention of unplanned extubation of neonates in NICU.Methods We selected 756 children with catheters who were admitted in NICU from March 1 st ,2015 to February 28th,2016 as experimental group.The experimental group was treated with the cluster nursing.The management included the full evi-dence-based diagnosis,the cluster management strategy for preventing unplanned extubation,the usage of 3 T calm,the safe care assess-ment sheet for assessing risk factors of tubs,and the improvement of human resource management mode.All nurses were trained.They then participated in the cluster nursing after qualification by examination.We also selected 598 children with catheters who were admit-ted in NICU from January 1stto December 31st,2014 as controlled group.The control group was treated with conventional nursing.The incidences of the unplanned extubation were compared were compared between the two groups.Results There were 1167 times of catheters in the experimental group in which 66 times of unplanned extubation occurred （ incidence =5.66%） .In contrast,there were 940 times of catheters in the controlled group in which 165 times of unplanned extubation occurred （ incidence =17.45%） .The differ-ences were statistically significant（χ2=75.65,P〈0.01）.Conclusion Application of the cluster intervention management can effec-tively decrease the incidence of the unplanned extubation in NICU to ensure the treatment effect and safety of children.

关 键 词：集束化 非计划拔管 联合护理措施 新生儿重症监护室(NICU) 

分 类 号：R248.4[医药卫生—中医临床基础]