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作 者:许骁玮[1] 王华芬 冯洁惠[1] 高春华[2] 林燕[2] 卫建华[3] 卢芳燕 黄昉芳[2] 赵丹丹[4] 徐燕[5] XU Xiaowei;WANG Huafen;FENG Jiehui;GAO Chunhua;LIN Yan;WEI Jianhua;LU Fangyan;HUANG Fang-fang;ZHAO Dandan;XU Yan
机构地区:[1]浙江大学医学院附属第一医院护理部,杭州市310003 [2]浙江大学医学院附属第一医院综合监护室,杭州市310003 [3]浙江大学医学院附属第一医院外科监护室,杭州市310003 [4]浙江大学医学院附属第一医院心脏大血管外科,杭州市310003 [5]浙江大学医学院附属第一医院感染科,杭州市310003
出 处:《中华护理杂志》2023年第13期1608-1614,共7页Chinese Journal of Nursing
摘 要:总结新型冠状病毒感染重症患者救护中可转化ICU的组建及应急管理策略。主要内容包括:基于4S管理模型,围绕空间(space)、人员(stuff)、系统(system)、供给(supplies)4个核心问题,通过快速改造扩容、统筹共享设备、物品摆放目视化管理等快速建立可转化ICU;通过建立三库四级梯队、开展重症阶梯培训、采取分类授权加组合排班等进行人员管理;在系统层面,通过多学科协作机制和俯卧位通气关口前移,提高重症救治成功率;在供给层面,重点配置智慧监护系统,赋能高效护理,提供心理疏导,维护员工的心理健康。在可转化ICU的快速组建和运行中,通过实施应急护理管理策略,保证了重症救护的及时、有序、安全、高效,为其他机构紧急情况下建立和改造可转化ICU提供了理论和实践依据。This article summarizes a series of organization and contingency management strategies of convertible ICU in severe rescue of COVID-19.Based on the 4S management model,focusing on the 4 core issues of space,staff,system,and supplies,the convertible ICU was quickly established through rapid transformation and expansion,overall sharing of equipment,and visual management of material placement.Personnel management includes establishing 3 reservoirs and 4 echelons,carrying out severe illness training,and carrying out classification authorization and combined shift scheduling.At the system level,a multidisciplinary collaboration mechanism was established and the ventilation gateway was moved forward in the prone position to improve the success rate of critical care.At the supply level,the key configuration of the intelligent monitoring system enabled efficient care,and psychological counseling support was provided to maintain employee’s mental health.During the period of the convertible ICU of rapid establishment and operation,through the implementation of these strategies,the timely,orderly,safe and efficient treatment of critically ill patients was ensured.The experience and theoretical basis were provided for the establishment and transformation of convertible ICU for other institutions in emergency situations.
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