摘要目的 探讨ICU入住时机管理对危重患者预后的影响.方法 将449例ICU患者分为2组,试验组229例(80名护士)采取ICU入住时机管理模式,对照组220例(81名护士)采取科室疾病护理常规及分级护理,对其痊愈、死亡、ICU并发症发生等情况进行回顾性分析.结果 试验组护士ICU预警、危重患者护理评估、心律失常识别、腹内压监测及应用、危重患者沟通要素、焦虑抑郁评估好所占比例分别为50.00%(40/80)、51.25%(41/80)、48.75%(39/80)、47.50%(38/80)、48.75%(39/80)、46.25%(37/80),对照组分别为7.41%(6/81)、6.17%(5/81)、9.88%(8/81)、8.64%(7/81)、7.41%(6/81)、6.17%(5/81),2组比较差异有统计学意义(χ2=29.42~40.07,P<0.01);试验组护士岗位胜任力维度中帮助角色、教育指导、管理能力、确保质量、工作角色得分及总分分别为(78.23±10.25)、(76.15±10.89)、(77.06±11.88)、(77.85±10.93)、(78.54±10.29)、(552.96±82.58)分,对照组分别为(72.23±10.21)、(70.23±11.20)、(70.23±12.03)、(72.36±10.44)、(73.52±10.81)、(503.61±84.39)分,2组比较差异有统计学意义(t=5.041~7.420,P<0.01),而诊断能力与诊疗干预得分试验组与对照组比较差异无统计学意义(P>0.05);试验组患者痊愈率、病死率、ICU并发症发生率分别为91.70%(210/229)、1.31%(3/229)、6.99%(16/229),对照组分别为70.00%(154/220)、6.82%(15/220)、25.00%(55/220),2组比较差异有统计学意义(χ2=34.44、8.85、27.35,P<0.01);观察组ICU入住时间为(6.18±3.16)d,对照组为(11.52±3.39)d,2组比较差异有统计学意义(t=12.273,P<0.01).结论 ICU入住时机管理的建立及应用,可以有效提升护士对潜在危重症的认知及岗位胜任力,并且提高了ICU患者治愈率,减少患者住ICU时间和降低ICU并发症的发生.

abstractsObjective To explore the effects of ICU admission time management on the prognosis of critically ill patients. Methods A total of 449 patients in ICU were selected and divided into experimental group (229 patients and 80 nurses) and control group (220 patients and 81 nurses). The experimental group was given ICU admission time management, and the control group was given routine nursing and grading nursing. The prognostic data including the cure rate, mortality and the incidence of complication were analyzed retrospectively. Results The scores of ICU early warning, critical patient care assessment, arrhythmia identification, intracavitary pressure monitoring and application, critically ill patients′communication factors and assessment of anxiety and depression were 50.00%(40/80), 51.25%(41/80), 48.75%(39/80), 47.50%(38/80), 48.75%(39/80), 46.25%(37/80) in experimental group, and those in control group were 7.41%(6/81), 6.17%(5/81), 9.88%(8/81), 8.64%(7/81), 7.41%(6/81), 6.17%(5/81), there were significant differences(χ2=29.42-40.07, P<0.01). Help role, education guidance, management ability, ensure quality, work role and the total score of the nurses′ position competence dimension in experimental group were (78.23 ± 10.25), (76.15 ± 10.89), (77.06 ± 11.88), (77.85 ± 10.93), (78.54 ± 10.29), (552.96±82.58) points respectively, and those in control group were (72.23±10.21), (70.23±11.20), (70.23± 12.03), (72.36±10.44), (73.52±10.81), (503.61±84.39) points, there were significant differences (t=5.041-7.420, P<0.01). There was no significant difference in diagnosis ability and diagnostic interventions (P>0.05). The cure rate, mortality and the incidence of complication in experimental group were 91.70%(210/229), 1.31%(3/229), 6.99%(16/229) , and those in control group were 70.00%(154/220), 6.82%(15/220), 25.00%(55/220), there were significant differences (χ2=34.44, 8.85, 27.35,P<0.01). ICU stay time in experimental group was (6.18±3.16) d, and that in control group was (11.52±3.39) d, there was significant difference(t=12.273,P<0.01). Conclusions Applying continuous special management in ICU admission time can increase the cure rate and decrease the hospitalization time and the incidence of complication.