重症医学亚专科护理模式的构建  

Construction of nursing mode for sub specialty of critical care medicine

作　　者：刘远金[1] 文艺[1] 黄玉敏[1] 张理[1] 兰莫莉[1] 张芳[1] Liu Yuanjin;Wen Yi;Huang Yumin;Zhang Li;Lan Moli;Zhang Fang(Liuzhou People＇s Hospital of Guangxi Province,Liuzhou Guangxi 54500)

机构地区：[1]广西柳州市人民医院,广西柳州545005

出　　处：《护士进修杂志》2018年第18期1649-1652,共4页Journal of Nurses Training

摘　　要：目的探寻重症护理专科化道路建设的有效模式,提高重症护理质量。方法在重症科建立神经重症、呼吸重症(兼机械通气)、心外重症(兼血流动力学监测)、普外重症、血液净化、PICC、造口伤口、重症营养支持8个护理亚专科学组,将经过5年ICU规范化培训的护士纳入到各亚专科组,从学科带头人的准入标准及小组的专业职责、工作形式加以规范,完成各专业组护士培训,与亚专科医疗团队合作,完成对应病种的监护工作。结果呼吸机相关性肺炎(VAP)发病率、中心静脉置管相关血流感染(CRBSI)发病率、留置导尿管相关泌尿系统感染(CAUTI)发病率、人工气道脱出例数、压疮发生率明显下降(P<0.05);护士职业认同感及工作质量明显提高(P<0.05)。结论ICU实施亚专科化护理模式,能有效培养各专科护理人才梯队,支撑学科发展,提高重症护理质量。Objective To study the effective mode of intensive care specialist construction and improve the quality of critical care.Methods The 8 sub-science groups were established,including severe neurosis,severe breathing（and mechanical ventilation）,severe external heart disease（and hemodynamic monitoring）,external intensive care,blood purification,PICC,stoma wound and severe nutritional support in the severe department.The nurses who trained for 5 years were included in the sub specialist group as the subject leader.The admittance standard and professional responsibility and work form of the group are standardized,the nurse training of various professional groups is completed,and the sub specialist medical team is worked together to complete the monitoring of the corresponding disease.Results The incidence of ventilator-associated pneumonia,incidence of central venous catheter related blood flow infection,incidence of urinary catheter related urinary system infection and the number of cases of artificial airway dislocation,and the incidence of pressure ulcers were significantly decreased（P〈0.05）,and the occupational identity and work quality of nurses were significantly improved（P〈0.05）.Conclusion The implementation of subspecialization nursing mode in ICU can effectively train the echelon of nursing professionals,support the development of disciplines and improve the quality of critical care.

关 键 词：重症医学 亚专科 专科护士 护理质量 

分 类 号：R473[医药卫生—护理学] R459.7[医药卫生—临床医学]