危重病人非预期48小时内重返ICU的原因分析及管理  

Cause Analyses and Management of Unexpectedly Returning Toicu within 48 Hours in Critical Care Patients

作　　者：李杏崧[1] 李绮慈[1] 魏雅娟[1] 邝杏娥[1] 邝景云[1] LI Xingsong;LI Qici;WEI Yajuan;KUANG Xinge;KUANG Jingyun

机构地区：[1]佛山市第一人民医院,广东佛山528000

出　　处：《现代医院》2018年第4期488-490,共3页Modern Hospitals

摘　　要：目的通过干预,减少危重病人非预期48小时内重返ICU。方法回顾分析2016年1月-12月转出ICU的危重病人在病房48小时内非预期重返的主要影响因素,将该组病人设为对照组。将2017年1月-12月转出ICU的危重病人设为研究组,对该组病人实施住ICU期间的高危重返评估、建立档案、提前护理干预、多学科护理合作及转出后护理跟踪服务。两组病人均经过医疗评估,符合转出ICU的条件,同时两组病人均执行护理程序实施护理。结果两组病人转出前的年龄、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分等指标比较均无明显统计学差异(P>0.05);研究组转出后48小时内重返ICU的病人数较对照组明显减少。结论提前护理干预与多学科护理合作模式的开展,使到危重病人的护理重点有专人跟进,延续之前有效的护理措施,明显减少护理不良事件的发生。Objective Adopting appropriate intervention to reduce the number of patients return to ICU unexpectedly within 48 hours. Methods A retrospective analysis was carried out from January 2016 to December 2016,to identify the main factors influencing the patients returning to ICU from general wards unexpectedly within 48 hours. The patients in this group were set as control group. Then,from January 2017 to December 2017,the patients transferring to general wards were set as trial group,measures such as assessing patients with high risk of returning,establishing files,taking early nursing interventions,as well as launching multidisciplinary nursing cooperation and providing nursing tracking services out of ICU were carried out. The patients in both groups were evaluated by clinicians,to make sure they reached the conditions of transferring out of ICU,meanwhile both received programmed nursing procedures. Results There was no significant difference in age and acute physiology and chronic health evaluation system II（ APACHE II） scores before the transferring（ P〈0. 05）. The number of patients returning to ICU within 48 hours in the trial group was significantly lower than that in the control group.Conclusion The development of early nursing intervention and multidisciplinary nursing cooperation mode facilitated patients followed-up,extended effective nursing measures,and significantly reduced the incidence of nursing adverse events.

关 键 词：护理干预 多学科合作 危重病人 重返ICU 

分 类 号：R473[医药卫生—护理学]