1849例新冠肺炎危重症患者密集护理特征及其管理  

Characteristics and practice management of intensive nursing care for 1849 COVID-19 patients

作　　者：汪晖 徐蓉[1] 胡露红[1] 黄丽红 王颖[1] 乐霄 胡凯利 尹世玉 Wang Hui;Xu Rong;Hu Luhong;Huang Lihong;Wang Ying;Yue Xiao;Hu Kaili;Yin Shiyu(Nursing Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,武汉430030

出　　处：《中华医院管理杂志》2020年第4期307-311,共5页Chinese Journal of Hospital Administration

摘　　要：目的探索分析新型冠状病毒肺炎患者密集护理需求特征及其产生原因。方法采用横断面研究设计,基于医院信息管理系统,提取某危重症患者救治定点医院某日所有重型和危重型新型冠状病毒肺炎患者的治疗及护理信息,采用描述性分析统计患者一般资料、护理等级、治疗性密集护理需求,采用χ2检验或Fisher精确检验分析不同特征患者在护理等级上的差异性。结果共提取1849例重型和危重型患者数据,其中,特级护理697例(37.70%),I级护理1152例(62.30%);年龄≥65岁患者893例(48.30%),具有1种及以上合并症患者853例(46.13%)。所有患者均需执行感染科护理常规,治疗性密集护理项目依次排序为静脉采血(99.62%)、氧气吸入(98.92%)、口服药(98.65%)、指脉氧监测(77.07%)和咽拭子采集(71.93%)。性别、年龄、入院方式、体位、合并症不同的患者,其护理级别的差异有统计学意义(P<0.05)。结论新型冠状病毒肺炎患者密集护理需求复杂,护理工作任务繁重、难度较大、专业化要求较高,在治疗、生活和心理方面均具有特殊性,尤其需特别关注老年患者和具有合并症患者。统一协调护理人力配备和护理质量管理工作,组建护理专家会诊团队,可进一步提升危重症患者照护品质。Objective To explore and analyze the characteristics and causes of intensive nursing needs of COVID-19 patients.Methods This was a cross-sectional study.Critical patients′treatment and care information were extracted through the HIS system of a designated hospital from critical patients with COVID-19.We used statistical descriptions to analyze patient general information,nursing degree,and therapeutic intensive care needs.The chi-square test or Fisher′s exact test was used to analyze the differences between characteristics of patients and nursing degree.Results A total of 1849 cases of critical patients were collected,including special grade nursing care 697(37.70%),grade I nursing care(62.30%).There were 893(48.30%)patients aged≥65 years,and 853(46.13%)patients with one or more complications.All patients required the nursing routine of infection department,and the therapeutic intensive care followed was vein blood collection(99.62%),oxygen inhalation(98.92%),oral medication(98.65%),finger pulse oxygen monitoring(77.07%)and pharyngeal swab collection(71.93%).The nursing degree of the patients with different gender,age,admission mode,body position and complications were statistically significant(P<0.05).Conclusions The intensive care nursing needs of COVID-19 patients are complex,which are special in treatment,life and psychology,and the tasks of nursing are heavy,difficult and professional.Special attention should be paid to elderly patients and patients with complications.Our hospital has established a provisional nursing department during the COVID-19 outbreak,coordinated nursing manpower and quality of nursing management,and set up a nursing expert consultation team to further enhance the quality of nursing care for critical COVID-19 patients.

关 键 词：新型冠状病毒肺炎 密集护理 护理级别 护理工作量 

分 类 号：R473[医药卫生—护理学]