[1]安然王晓慧范宇莹孙笑影张莲棠.成人危重症患者分级护理研究[J].中国卫生质量管理,2021,28(11):054-57.[doi:10.13912/j.cnki.chqm.2021.28.11.13 ]
　AN Ran,WANG Xiaohui,FAN Yuying.Hierarchical Nursing of Adult Critically Ill Patients[J].Chinese Health Quality Management,2021,28(11):054-57.[doi:10.13912/j.cnki.chqm.2021.28.11.13 ]
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成人危重症患者分级护理研究
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年11期
页码:
054-57
栏目:
护理质量
出版日期:
2021-11-28

文章信息/Info

Title:
Hierarchical Nursing of Adult Critically Ill Patients
作者:
安然王晓慧范宇莹孙笑影张莲棠
哈尔滨医科大学护理学院
Author(s):
AN Ran; WANG Xiaohui; FAN Yuying
Nursing School of Harbin Medical University
关键词:
重症监护病房; 分级护理; 聚类分析; 护理工时; 护理质量
Keywords:
Intensive Care Unit;  Hierarchical Nursing;  Cluster Analysis;  Nursing Hours;  Quality of Care
分类号:
R47
DOI:
10.13912/j.cnki.chqm.2021.28.11.13
文献标志码:
A
摘要:
目的探索成人危重症患者分级护理方案，以期为重症监护病房实施分级护理管理提供参考。方法于2019年5月-11月，以课题组前期研究为基础，采用危重症患者病情严重程度评估体系和护理工时评估体系共16个变量对300例ICU住院患者进行测评，应用聚类分析方法进行数据降维，确定护理分级。结果300例成人危重症患者聚类为三个护理亚群，并根据类属特征将其命名为特A级护理、特B级护理和特C级护理。特A级护理亚群患者病情最重，所需护理工时最长；特B级护理亚群呈现两种情况，一种为患者病情严重但所需护理工时较短，另一种为患者病情较轻但所需护理工时较长；特C级护理患者病情最轻，所需护理工时最短。结论基于聚类分析法确定的成人危重症患者分级护理方案科学性较好，初步获得分级护理基本特征，能够为危重症患者分级护理管理提供参考。
Abstract:
ObjectiveTo explore the hierarchical nursing plan for adult critically ill patients and to provide reference for the implementation of hierarchical nursing management in Intensive Care Unit (ICU).MethodsFrom May to November, 2019, based on the preliminary research, 300 ICU inpatients were evaluated with 16 variables of the severity assessment system and nursing work hour evaluation system of critical ill patients, and cluster analysis method was used for data dimensionality reduction to determine the nursing grade. Results300 adult critically ill patients were grouped into three nursing subgroups, which were named as special grade A nursing, special grade B nursing and special grade C nursing according to their category characteristics. Patients in the special grade A nursing subgroup were the sickest and needed the longest nursing hours. The special B nursing subgroup presented two conditions, one for patients with severe conditions but short nursing hours, and the other for patients with mild conditions but long nursing hours. The special C grade nursing patients were the least ill and required the shortest nursing hours.Conclusion The hierarchical nursing plan for adult critically ill patients based on cluster analysis method was scientific, and the basic characteristics of the hierarchical nursing were obtained preliminarily, which can provide reference for the hierarchical nursing management of critically ill patients.

参考文献/References:

［1］阮一鸣,吴骋,贺佳.患者病情分级系统在重症监护室护理工作中应用的现况与进展［J］.解放军护理杂志,2019,36(9):42-44，74. ［2］谢彩霞,肖静蓉,周敏,等.护理分级质量改进的实践及成效［J］.中华护理杂志,2015,50(6):716-719. ［3］张雅婷.APACHEⅡ评分在ICU临床分级护理中的应用体会［J］.中医药管理杂志,2017,25(1):118-120. ［4］周艳红,李乐之,谢霞,等.3种评分系统在心脏外科ICU护理人力资源配置中的适用性研究［J］.中华护理杂志,2015,50(5):570-573. ［5］Flo J,Landmark B,Tnnessen S,et al . Patient classification systems used to classify nursing intensity and assess nursing staffing resources in home health care: a scoping review［J］.International Journal of Nursing Studies,2019,99：103361. ［6］Vranas KC, Jopling JK, Sweeney TE,et al. Identifying distinct subgroups of ICU patients: a machine learning approach［J］.Critical Care Medicine, 2017,45(10):1607-1615. ［7］Rajkomar A, Dean J, Kohane I. Machine learning in medicine［J］.N Engl J Med,2019,380(14):1347-1358. ［8］Kiekkas P, Brokalaki H, Manolis E, et al. Patient severity as an indicator of nursing workload in the intensive care unit［J］.Nursing in Critical Care, 2007, 12(1):34-41. ［9］Adomat R, Hewison A. Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches［J］.Journal of Nursing Management, 2004, 12(5):299-308. ［10］管向东,欧阳彬,黎毅敏.ICU诊疗指引与管理规范［M］.广州：广东科技出版社,2009:387-388. ［11］张悦,范宇莹,王晓慧,等.重症监护病房成人护理工时评估体系的构建［J］.护理研究,2020,34(11):1915-1920. ［12］沙丽,苏兰若.应用护理活动评估量表对 ICU 护理工作量的调查与分析［J］.中华护理杂志,2007,42(7):591-594. ［13］肖顺贞. 临床科研设计［M］.北京：北京大学医学出版社,2008:151. ［14］中华医学会重症医学分会.中国重症加强治疗病房(ICU)建设与管理指南(2006)［J］.中国危重病急救医学,2006,18(7):387-388. ［15］陈明,万廷信,戴恩来,等.基于因子分析与聚类分析的IgA肾病中医证候分类研究［J］.北京中医药大学学报,2014,37(2):135-140. ［16］杨俊闯,赵超.K-Means聚类算法研究综述［J］.计算机工程与应用,2019,55(23):7-14，63. ［17］黎丽芬,管向东,董丹丹,等.重症医学科如何安全合理使用药物［J］.中国卫生质量管理,2013,20(1):24-27. ［18］梅丽芳,康雅琴,朱红.分层次管理对ICU护理质量及护士职业疲惫感的影响［J］.中国卫生质量管理,2016,23(3):71-73.

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更新日期/Last Update: 2021-11-28