构建神经外科ICU危重患者过渡期Y型路径标准化护理模式
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发布人:yaot 发布时间:2021/1/21 10:48:31  浏览次数:2371次
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——关亚庆 张晓阳 闫淑娟 王蕾 黄田张 吴玉燕*



【摘要】按照课题研究型品管圈活动步骤,从普通病房、神经外科ICU、社区医院等方面了解ICU危重患者过渡期护理现状,重点发掘评估、转运、交接、回访等环节,针对存在问题,从组织与培训、多学科协作、标准化干预、护理模式等方面改进。活动后,转运总耗时由51.96min缩短至26min,ICU重返率由7.18%下降至4.76%,ICU后综合征发生率由68.21%下降至52.16%,降低了不良事件发生风险,保障了患者安全,临床效果显著。
【关键词】品管圈;课题研究型品管圈;ICU;过渡期;标准化护理;护理质量
中图分类号:R197.323;R47文献标识码:B
Constructing the Transitional Period Y-Type Pathway Standardized Nursing Model for Critical ICU Patients in Neurosurgery Department/GUAN Yaqing,ZHANG Xiaoyang,YAN Shujuan,et al.//Chinese Health Quality Management,2020,27(6):96-102
Abstract According to the activity steps of research-oriented quality control circle, the current situation of transitional care was investigated from general wards, neurosurgical ICU, community hospitals and other aspects, and it was focused on the evaluation, transfer, handover, return visit and other links. In view of existing problems, improvements were made from aspects of the organization and training, multidisciplinary collaboration, standardized intervention, nursing mode, etc. After the activity, the total transport time was shortened from 51.96 min to 26 min, the ICU re-entry rate was reduced from 7.18% to 4.76%, and the incidence of post-ICU syndrome was reduced from 68.21% to 52.16%, which reduced the risk of adverse events, ensured the safety of patients, and achieved significant clinical effects.
Key words Quality Control Circle;Research-Oriented Quality Control Circle; ICU;Transition Period; Standardized Care; Nursing Quality
Firstauthor's address Second Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanxi,710038,China



1主题选定

   圈员从有效性、可行性、经济性、时间性、 自主性5方面,对4个备选课题按5-3-1评分法进行筛选,选定得分最高的“构建神经外科ICU危重患者过渡期Y型路径标准化护理模式”为本期活动主题。经QC-Story判定,本期活动主题为课题研究型。
   选题背景:ICU收治患者经治疗处置,病情相对稳定后,由ICU转至普通病房、当地医院或回归家庭予以进一步康复治疗,处于这一阶段的患者称为ICU过渡期患者。临床工作中,经常出现过渡期患者病情突然变化,被迫再次返回ICU的现象。研究显示,经过渡期护理干预,护理不良事件发生率由7.3%下降到2.5%[1],ICU重返率由5.4%降低至4.8%,同时降低了ICU后综合征发生风险[2]。但多数医疗机构对ICU过渡期护理关注不足,多停留在满意度访视阶段,不能为ICU转出患者提供安全保障[3]。调查发现,空军军医大学第二附属医院神经外科ICU实施无陪护制度,患者转出后在护理级别、人员配比、仪器设备、专业技能、专人管理等方面与ICU均有较大差别,不能满足专业护理延续性要求,更无法保障过渡期患者安全。

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原文链接:构建神经外科ICU危重患者过渡期Y型路径标准化护理模式