胸心外科护士主导的谵妄风险针对性预防联合阶段性目标护理在主动脉夹层患者围术期的应用  

Perioperative application of nurse-led targeted prevention of delirium risk combined with phased targeted nursing in patients with aortic dissection in thoracic and cardiac surgery

作　　者：李秀娥[1] 柴秀平[1] 刘鑫 Li Xiu′e;Chai Xiuping;Liu Xin(Department of Nursing,the Second People's Hospital of Liaocheng City,Liaocheng 252601,China;Thoracic and Cardiac Surgery,the Second People's Hospital of Liaocheng City,Liaocheng 252601,China)

机构地区：[1]聊城市第二人民医院护理部,聊城252601 [2]聊城市第二人民医院胸心外科,聊城252601

出　　处：《国际护理学杂志》2024年第13期2353-2358,共6页international journal of nursing

摘　　要：目的研究胸心外科护士主导的谵妄风险针对性预防联合阶段性目标护理在主动脉夹层(aortic dissection,AD)患者围术期的应用效果。方法选取2019年9月至2022年9月聊城市第二人民医院收治的AD患者89例作为研究对象。按照随机数字表法分为观察组(45例)和对照组(44例)。对照组采用常规护理干预,观察组采用胸心外科护士主导的谵妄风险针对性预防联合阶段性目标护理。比较两组患者干预前后的临床指标、谵妄发生率、谵妄持续时间、谵妄严重程度、镇静状态、睡眠情况以及护理满意度。结果干预后,观察组的机械通气时间、ICU停留时间、谵妄发生率及谵妄持续时间低于对照组(P<0.05);观察组谵妄严重程度评定量表(confusion assessment method-severity,CAM-S)评分、躁动镇静评分量表(Richmond agitation-sedation scale,RASS)评分绝对值低于对照组,理查兹-坎贝尔睡眠量表(Richards-campbell sleep questionnaire,RCSQ)评分高于对照组(P<0.05);观察组护理内容、健康教育、谵妄预防、心理关怀及环境管理的满意度评分高于对照组(P<0.05)。结论胸心外科护士主导的谵妄风险针对性预防联合阶段性目标护理能有效缓解AD患者的临床指标,降低谵妄发生率,改善谵妄情况和镇静状态,提高睡眠质量及护理满意度。Objective To study the effectiveness of nurse-led risk prevention of delirium combined with phased target nursing in perioperative aortic dissection(AD)patients.Methods A total of 89 AD patients admitted from September 2019 to September 2022 were selected as the study objects.According to random number table method,they were divid`ed into observation group(45 cases)and control group(44 cases).The control group was treated with routine nursing intervention,and the observation group was treated with targeted prevention of delirium risk combined with phased target nursing led by nurses in thoracic and cardiac surgery.The clinical indicators,incidence of delirium,duration of delirium,severity of delirium,sedation,sleep and nursing satisfaction of the two groups were compared before and after intervention.Results After intervention,the mechanical ventilation time,ICU stay time,delirium incidence and delirium duration in observation group were lower than those in control group(P<0.05).The confusion assessment method-severity(CAM-S)and Richmond agitation-sedation scale(RASS)in the observation group were lower than those in the control group.The absolute value of score of Richards-campbell sleep questionnaire(RCSQ)in the observation group was higher than that in the control group(P<0.05).Satisfaction scores of nursing content,health education,delirium prevention,psychological care and environmental management in observation group were higher than those in control group(P<0.05).Conclusions Targeted prevention of delirium risk led by nurses in thoracic and cardiac surgery combined with targeted stage nursing can effectively alleviate the clinical indicators of AD patients,reduce the incidence of delirium,improve delirium,sedation,sleep quality and nursing satisfaction.

关 键 词：胸心外科护士 谵妄风险 阶段性目标护理 主动脉夹层 

分 类 号：R473.6[医药卫生—护理学]