三级谵妄护理管理流程应用于儿科重症监护病房对患儿临床结局及护理人员护理能力的积极影响  

Effect of three-level delirium nursing management process on the treatment outcome and quality of care in the pediatric intensive care unit

作　　者：李广玉[1] 段颖杰[1] 王晓晖[1] 张洁[1] 曲斌[1] 徐杰 Li Guangyu;Duan Yingjie;Wang Xiaohui;Zhang Jie;Qu Bin;Xu Jie(Department of Critical Care Unit,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院重症医学科,100045

出　　处：《中国实用护理杂志》2020年第18期1361-1365,共5页Chinese Journal of Practical Nursing

基　　金：北京市医院管理中心青年人才培养“青苗”计划(QM120191207)。

摘　　要：目的:探究儿科重症监护病房(PICU)中采用三级谵妄护理管理流程对患儿治疗效果和护理人员护理能力的影响。方法:自2019年1月首都医科大学附属北京儿童医院针对PICU制订三级谵妄管理流程,实施6个月随机抽选75例患儿为试验组,选取2018年7—12月行常规护理的75例患儿为对照组,采用常规护理,对比2组患儿监护室谵妄(DICU)发生率、持续时间、PICU住院时间的差异;比较实施前后患儿家属对护理质量的满意度、PICU护士谵妄循证知识掌握情况。结果:试验组患儿DICU发生率为21.33%(16/75),DICU相关不安全事件发生率为2.67%(2/75),对照组依次为40.00%(30/75)、12.00%(9/75),差异有统计学意义(χ^2值为6.145、4.807,P<0.05);试验组DICU持续时间(14.16±4.25)h、ICU住院时间(48.62±8.85)h,均少于对照组的(17.37±5.36)、(52.03±8.10)h,差异有统计学意义(t值为2.070、2.462,P<0.05);2组DICU患者护理谵妄筛查量表评分(Nu-DESC)差异无统计学意义(P>0.05),护理后试验组评分为(1.72±0.75)分,低于对照组的(2.17±0.63)分,差异有统计学意义(t值为2.159,P<0.05);护理质量评价问卷调查结果显示试验组家属对护理服务的满意度93.33%(60/75),高于对照组的82.67%(52/75),差异有统计学意义(χ^2值为4.040,P<0.05)。实施后护士对谵妄循证知识问卷中"谵妄危险因素"问题的答对率显著高于实施前(P<0.05),实施6个月后谵妄循证知识评分为(6.82±1.74)分,较实施前的(4.26±0.85)分提高,差异有统计学意义(t值为3.739,P<0.01)。结论:在PICU内开展三级谵妄护理管理流程可更好地预防患儿谵妄发生,加强护理服务质量,锻炼护理人员的综合素质。Objective To explore the effect of three-level delirium nursing management process on the treatment outcome and quality of care in the pediatric intensive care unit(PICU).Methods Since January 2019,three-level delirium management process for PICU were developed.75 children were randomly selected as the experimental group for 6 months,and 75 patients who received routine care between July and December 2018 were selected as the experimental group.The control group received routine nursing care,and compared the differences in the incidence,duration,and length of PICU stay in the intensive care unit(DICU)between the two groups of children.The family members'satisfaction with the quality of care and the evidence-based knowledge of PICU nurses were compared before and after implementation.Results The incidence of DICU in the experimental group was 21.33%(16/75),the incidence of unsafe events related to DICU was 2.67%(2/75),and the control group was 40.00%(30/75),12.00%(9/75).The difference was statistically significant(χ^2 values were 6.145,4.807,P<0.05);the duration of the DICU in the test group(14.16±4.25)hours,and the length of ICU hospitalization(48.62±8.85)hours were less than(17.37±5.36)hours and(52.03±8.10)hours in the control group,the difference was statistically significant(t values were 2.070,2.462,P<0.05);The score of Nursing Delirium Screening Scale(Nu-DESC)for nursing care of DICU patients in the two groups was not statistically significant(P>0.05).The score of the test group after nursing was(1.72±0.75)points,which was lower than(2.17±0.63)points of the control group.The difference was statistically significant(t value was 2.159,P<0.05);The results of the nursing quality evaluation questionnaire showed that the satisfaction of family members in the test group with respect to nursing services was 93.33%(60/75),which was higher than 82.67%(52/75)in the control group,with a significant difference(χ^2 value was 4.040,P<0.05).After the implementation,the correct answer rate of the"risk factors for del

关 键 词：儿科重症监护病房 三级谵妄护理 管理流程 谵妄 满意度 

分 类 号：R473.72[医药卫生—护理学]