儿科ICU护士仪器设备报警疲劳风险预测模型的构建  

Construction of equipment alarm fatigue risk prediction model for pediatric ICU nurses

作　　者：刘巧红[1] 王洁[1] 段永珂[2] 周会月 祁睿华 Liu Qiaohong;Wang Jie;Duan Yongke;Zhou Huiyue;Qi Ruihua(Surgical Intensive Care Unit,Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450000,China;Department of Medicine,Kaifeng University,Kaifeng 475004,China;School of Nursing and Health,Zhengzhou University,Zhengzhou 450001,China;PICU,Kaifeng Children's Hospital,Kaifeng 475099,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院外科监护室,郑州450000 [2]开封大学医学部,开封475004 [3]郑州大学护理与健康学院,郑州450001 [4]开封市儿童医院PICU,开封475099

出　　处：《中华现代护理杂志》2022年第22期3016-3021,共6页Chinese Journal of Modern Nursing

摘　　要：目的探讨儿科ICU护士仪器设备报警疲劳风险的影响因素,并建立预测模型验证其预测效能。方法采用多阶段抽样法选取2020年10月—2021年3月河南省2所三级儿童专科医院的300名儿科ICU护士为研究对象进行模型构建,其中发放问卷300份,回收有效问卷225份。于2021年4—5月选取河南省儿童医院的110名儿科ICU护士用于模型验证,其中发放问卷110份,回收有效问卷100份。采用自制基线评分量表采集相关基线信息,采用医疗设备报警管理问卷及仪器设备报警疲劳相关量表进行调查,采用Logistic回归模型进行预测模型建立,Hosmer-Lemeshow检验模型拟合效果,采用受试者工作特征曲线进行预测价值评估。结果225名儿科ICU护士医疗设备报警管理因素得分为(48.67±4.35)分,医疗设备报警管理阻碍因素得分为(39.67±3.67)分,临床报警疲劳总分为(22.32±2.83)分。多因素分析结果显示,年龄<30岁、工作年限<5年、带病工作、护师及以下职称、倒班、无设置医疗设备警报的习惯、医疗设备管理因素均为儿科ICU护士仪器设备报警疲劳的独立危险因素(P<0.05)。本研究最终构建预测模型,模型受试者工作特征曲线下面积(AUC)为0.887,灵敏度为0.891,特异度为0.843。验证数据结果显示,模型AUC值为0.901,灵敏度为0.912,特异度为0.857。结论儿科ICU护士存在不同程度的仪器设备报警疲劳,本研究模型可对其仪器设备报警疲劳风险作出可靠预测,提示应对高风险因素给予重点关注,并及时开展措施干预,降低相关不良事件发生风险。Objective To explore the influencing factors of instrument and equipment alarm fatigue risk of nurses in pediatric intensive care unit(ICU),establish a prediction model and verify its prediction efficiency.Methods A multi-stage sampling method was used to select 300 pediatric ICU nurses from 2 tertiary children's specialized hospitals in Henan Province from October 2020 to March 2021 as the research objects for model construction.A total of 300 questionnaires were distributed and 225 valid questionnaires were recovered.From April to May 2021,110 pediatric ICU nurses in Henan Children's Hospital were selected for model validation,110 questionnaires were distributed and 100 valid questionnaires were recovered.A self-made baseline rating scale was used to collect relevant baseline information.The medical equipment alarm management questionnaire and the equipment alarm fatigue related scale were used for investigation.The Logistic regression model was used to establish the prediction model,Hosmer-Lemeshow test was used to test the fitting effect of the model and the receiver operating characteristic curve was used to evaluate the prediction value.Results The 225 pediatric ICU nurses scored(48.67±4.35)for medical equipment alarm management factors,(39.67±3.67)for obstacles to medical equipment alarm management and(22.32±2.83)for clinical alarm fatigue.The results of multivariate analysis showed that the factors of age less than 30 years old,working years less than 5 years,working with illness,nurses with professional titles below,shift work,no habit of setting medical equipment alarms,and medical equipment management factors were all pediatric ICU nurses'equipment alarm fatigue.The independent risk factor of ICU(P<0.05).In this study,a prediction model was finally constructed.The area under the receiver operating characteristic curve(AUC)of the model was 0.887,the sensitivity was 0.891 and the specificity was 0.843.The validation data results showed that AUC value of the model was 0.901,the sensitivity was 0.912 an

关 键 词：儿科 护士 重症监护室 仪器设备报警疲劳 风险 预测模型 

分 类 号：R472[医药卫生—护理学]