重症患者非计划重返ICU安全管理方案的建立及效果评价  

Construction and Evaluation of Safety Management Project for Unplanned ICU Readmission

作　　者：米元元 黄海燕[1] 陈卉[1] 陈汉珍[1] 明耀辉 聂涛[1] MI Yuan-yuan;HUANG Hai-yan;CHEN Hui;CHEN Han-zhen;MING Yao-hui;NIE Tao(Dept.of Critical Care Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;College of Public Health,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]华中科技大学同济医学院附属协和医院重症医学科,湖北武汉430022 [2]郑州大学公共卫生学院,河南郑州450001

出　　处：《护理学报》2022年第6期15-19,共5页Journal of Nursing（China）

基　　金：华中科技大学同济医学院附属协和医院教学改革研究项目(02.03.2019.15-41)。

摘　　要：目的探讨重症患者非计划重返ICU安全管理方案的可行性及其应用效果。方法方便抽样选取2019年1—12月转出ICU患者1241例作为对照组,采用ICU转科常规安全护理措施。选取2020年1—11月转出ICU患者1082例作为观察组,并采用重症患者非计划重返ICU安全管理方案。比较2组患者非计划重返ICU的发生率、2组患者重返ICU原因分析和2组患者ICU平均住院时长的差异。结果观察组非计划重返ICU发生率、ICU平均住院时长低于对照组,差异有统计学意义(P<0.05)。观察组患者因低氧原因重返ICU的例数少于对照组,差异具有统计学意义(P<0.05);与对照组相比,观察组患者未出现因CO_(2)潴留、心力衰竭、低血压、电解质紊乱等重返ICU,但差异无统计学意义(P>0.05);与对照组相比,观察组患者因胃肠道出血重返ICU的例数,差异无统计学意义(P>0.05);观察组患者因误吸(1例)和低血糖(1例)重返ICU的例数高于对照组,但差异无统计学意义(P>0.05)。结论对ICU患者实施重症患者非计划重返ICU安全管理方案具有可行性及有效性,可降低重症患者重返ICU的发生率,缩短ICU住院时长。Objective To explore the feasibility and application of safety management project of unplanned readmission to ICU in severe patients. Methods With convenience sampling method, 1,241 patients meeting the inclusion criteria from January to December 2019 were included into control group and 1,082 patients from January to November 2020 in experimental group. Routine nursing care was implemented in the control group, while safety management project for unplanned ICU readmission was conducted in the experimental group. The rate of unplanned ICU readmission, the causes of ICU readmission and the average length of stay in ICU in the two groups were compared. Results The rate of unplanned ICU readmission in the experimental group was significantly lower than that in the control group(P<0.05). The average length of stay in ICU in the experimental group was shorter than that in the control group(P<0.05). There were less patients readmitted to ICU due to hypoxia(P<0.05) and no patients readmitted to ICU due to CO_(2) retention, heart failure, hypotension, and electrolyte in the experimental group(P>0.05). Comparison of the number of patients readmitted to ICU due to gastrointestinal bleeding in the two groups indicated no statistical significance( P>0.05). There were more patients in the experimental group readmitted to ICU due to aspiration and hypoglycemia but no statistical significance was found( P>0.05). Conclusion With lower ICU readmission rates and shorter average length of stay in ICU, it is feasible and effective to implement the safety management project of unplanned readmission to ICU in severe patients.

关 键 词：重症监护 重返率 护理管理 护理安全 

分 类 号：R459.7[医药卫生—急诊医学] R473[医药卫生—治疗学]