医护人员执行脓毒症1 h集束化治疗管理体系的依从性研究初探  

The implementation of hour-1 bundle for sepsis in medical staff

作　　者：钱淑媛[1] 李雪珠 周洁 刘玲[1] 谢剑锋[1] 黄英姿[1] 李晓青[1] Qian Shuyuan;Li Xuezhu;Zhou Jie;Liu Ling;Xie Jianfeng;Huang Yingzi;Li Xiaoqing(Department of Critical Care Medicine,Zhongda Hospital,School of Medicine,Southeast University,Jiangsu Provincial Key Laboratory of Critical Care Medicine,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院重症医学科,江苏省重症医学重点实验室,南京210009

出　　处：《中华内科杂志》2022年第1期104-107,共4页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金面上项目(81971812);江苏省重点研发计划(社会发展)项目(BE2021734);南京市卫生科技发展专项资金项目(YKK18257)。

摘　　要：探讨医护人员执行脓毒症1 h集束化治疗管理体系的依从性。构建脓毒症1 h集束化治疗执行管理体系,收集构建前3个月、构建过程(9个月)及构建完成后3个月的286例脓毒症患者,分析执行管理体系构建前(对照组)、构建过程(观察组)及构建后(实施组)医护人员对1 h集束化治疗的依从性。结果显示,随着执行管理体系的应用及实施,医护人员对脓毒症1 h集束化治疗的依从性对照组为58.3%,观察组为69.1%,实施组为88.4%,差异有统计学意义(χ^(2)=7.053,P=0.029)。脓毒症患者28 d病死率对照组为41.7%,观察组为34.9%,实施组为23.3%,实施组患者的病死率最低,但未达统计学意义(χ^(2)=5.576,P=0.062)。脓毒症1 h集束化治疗执行管理体系可有效提高医护人员集束化治疗的依从性。To determine the physicians′compliance of hour-1 bundle for sepsis.A management system of hour-1 bundle for sepsis was established.The clinical data of 286 sepsis patients were collected,who were classified into 3 months before the bundle(control group),9 months during process(observation group)and 3 months after bundle(study group).The compliance of hour-1 bundle implementation was compared in three groups.The results showed that with the application and implementation of the management system,the compliance of hour-1 bundle for sepsis in the control group,observation group and study group was 58.3%(28/48),69.1%(105/152)and 88.4%(76/86)respectively(χ^(2)=7.053,P=0.029).The 28 day mortality in sepsis patients was 41.7%(20/48),34.9%(53/152)and 23.3%(20/86)respectively(χ^(2)=5.576,P=0.062).The management system of hour-1 bundle for sepsis can effectively improve the physicians′compliance.

关 键 词：脓毒症 1小时集束化治疗策略 依从性 执行管理体系 

分 类 号：R459.7[医药卫生—急诊医学]