ICU危重患者实施眼部护理状况的调查分析

目的 了解与探讨ICU护士对危重患者眼部护理实施情况,进而有针对性制订培训方案与眼部护理指南,以提高护士对危重患者眼部护理的技能水平.方法 采用自行设计问卷,应用非随机取样法对本市2所综合医院92名ICU护士进行问卷调查,了解其对ICU危重患者实施眼部护理状况.结果 ICU护士对危重患者眼部护理实施情况不容乐观,缺乏统一标准.结论 应加强ICU护士专业理论知识培训学习,制订眼部护理指南,从而全面提高对危重患者的眼部护理水平.     

多中心ICU护士对重症患者早期康复认知的现状及影响因素研究

目的：基于多中心调查ICU护士对重症患者早期康复认知的现状并分析其影响因素。方法：采用便利抽样，在2022年11月至12月对天津市18所三级综合医院符合要求的ICU护士进行调查，采用一般资料调查表、ICU护士对重症患者早期康复认知问卷调查ICU护士对重症患者早期康复理论知识的认知程度以及康复技术实践能力，并探讨ICU护士对重症患者早期康复认知的影响因素。结果：ICU护士对重症患者早期康复整体认知得分为（3.86±0.63）分，其中康复理论知识、康复技术实践能力得分分别为（3.98±0.62）分、（3.76±0.72）分。多元线性回归显示，工作岗位、是否接受过早期康复相关的培训、科室内是否有早期康复方案、科室内是否有康复专职护士是ICU护士对重症患者早期康复认知的独立影响因素。结论：ICU护士对重症患者早期康复的整体认知处于中等水平，应进一步加强重症康复相关培训，提高康复技术临床实践能力，构建标准化实践方案，推动重症康复持续发展。     

大连市149名急重症监护病房护士ICU谵妄的知信行调查分析

目的了解急重症监护病房(emergence intensive care unit,EICU)护士对ICU谵妄知识、态度、行为现状,并分析ICU谵妄知识、态度及行为的相关性,为提高急重症监护病房护士ICU谵妄知识及护理技能提供依据。方法采用自行设计的ICU谵妄知识、态度、行为问卷,对大连市5所三级甲等医院的149名急重症监护病房护士进行调查,收集数据采用描述性分析、方差分析及Pearson相关分析。结果 149名急重症监护病房护士ICU谵妄知识、态度、行为得分分别为(21.26±5.34)分、(18.65±5.71)分、(10.86±3.40)分,得分均偏低。不同年龄、护理工作年限及急重症监护病房工作年限的护士在ICU谵妄知识掌握情况得分比较,差异有统计学意义(P0.05);不同年龄、性别的护士对ICU谵妄护理的态度得分比较,差异有统计学意义(P0.05);不同性别护士ICU谵妄护理行为得分比较,差异有统计学意义(P0.05)。急重症监护病房护士ICU谵妄知识与态度呈负相关(r=-0.19,P=0.02),对ICU谵妄的态度与行为呈正相关(r=0.64,P=0.00)。结论急重症监护病房护士ICU谵妄知识水平偏低,ICU谵妄认知态度欠积极,ICU谵妄患者评估及护理行为运用不足,需加强急重症监护病房护士ICU谵妄知识教育,端正其ICU谵妄预防和护理态度,提高其ICU谵妄护理运用能力,以减少急重症患者ICU谵妄的发生。     

ICU护士重症急性胰腺炎肠内营养治疗的知信行水平调查及影响因素分析

目的调查重症监护室(ICU)护士对重症急性胰腺炎肠内营养治疗的知信行水平现状, 并分析其影响因素。方法采用便利抽样法, 选取2022年2—4月河南省7所三级甲等医院520名ICU护士作为研究对象。采用一般资料调查表、临床护士急性胰腺炎肠内营养治疗知信行问卷进行调查。结果共发放问卷520份, 回收有效问卷504份, 有效回收率为96.92%。ICU护士重症急性胰腺炎肠内营养知信行总分为(113.68±12.48)分, 其中知识维度(10.67±2.58)分, 态度维度(61.60±6.38)分, 行为维度(41.42±7.44)分。ICU护士重症急性胰腺炎患者肠内营养知识、态度、行为得分之间呈正相关(P<0.01)。多重线性回归分析结果显示, 职称、从事ICU护理的工龄、人事关系、是否参加过专题培训、是否护理过重症急性胰腺炎肠内营养患者是知识维度的影响因素(P<0.05);职务、是否参加过专题培训、是否护理过重症急性胰腺炎肠内营养患者是态度维度的影响因素(P<0.05);性别、职称、职务、是否参加过专题培训、是否护理过重症急性胰腺炎肠内营养患者是行为维度的影响因素(P&...     

ICU患者眼部护理的证据总结

目的 :总结ICU患者眼部护理的相关证据,旨在完善ICU患者眼部护理管理及预防干预措施,为临床医护人员提供借鉴。方法 :计算机检索临床决策、指南网站、专业协会网站、各循证资源及文献数据库中关于ICU患者眼部护理相关内容的指南、临床决策、证据总结、系统评价,进行方法学质量评价后,根据主题对证据进行提取与汇总。结果 :共纳入13篇文献,通过阅读、提取、归类最终形成证据15项,包括ICU患者眼部护理标准及管理、评估、具体眼部问题护理方案、会诊、教育5个主题。结论 :医务人员应重视ICU患者眼部护理问题,遵照循证护理标准,根据实际情境选择实践证据,从而降低重症患者眼部并发症发生率,提高患者生存质量,推动循证知识向实践转化。     

重症昏迷监护患者不同眼部护理干预方法的效果评价

目的 探讨不同眼部护理干预方法对重症监护昏迷患者角膜的影响.方法 将ICU收治的120例患者随机分为干预1组、干预2组及常规护理组各40例.干预1组予清洁眼睑、贴敷无菌聚乙烯薄膜、冲洗结膜囊等措施.干预2组予清洁眼睑、定时滴注氧氟沙星眼凝胶等措施.常规护理组予以临床常规的治疗护理措施.以角膜上皮是否脱落为眼部并发症的评价指标对各组疗效进行评价.结果 干预后第3天3组的角膜上皮脱落情况比较差异无统计学意义,第5天时2个干预组的角膜上皮脱落情况显著优于对照组.结论 眼部护理干预可对重症昏迷患者角膜上皮细胞脱落有明显的治疗效果,可降低患者眼部相关并发症.     

某市三级医院ICU护士重症监护护理能力现状及影响因素分析

目的对某市三级医院ICU护士重症监护护理能力现状进行调查,并分析其影响因素。方法采用便利抽样法,于2018年1月—2月选取某市10所三级医院284名ICU护士进行网络问卷调查,调查工具包括一般资料调查表和重症监护护理能力量表。结果 284名ICU护士的重症监护护理能力得分为(4.19±0.47)分;在所有模块/维度中,"态度和价值观基础"得分最高,为(4.62±0.45)分;经验基础得分最低,为(3.92±0.66)分。多元回归分析显示护理工作年限、是否参加过ICU专科护士认证是ICU护士重症监护护理能力的主要影响因素(P0.001)。结论某市三级医院ICU护士的重症监护护理能力整体处于良好水平,但仍存在伦理行为和健康法规等薄弱环节。未来应加强针对性培训,全面提升ICU护士重症监护护理能力,从而使其能够为患者提供更加安全、优质的护理服务。     

重症监护室患者实施眼部护理干预对其眼部并发症发生率的影响

目的探讨眼部护理干预在重症监护室患者中使用对其眼部并发症发生率的临床影响。方法本次研究对象来源于本院重症监护室2015年9月~2016年9月收治的患者90例,随机分成两组,其中对照组(n=45)采用常规护理,观察组(n=45)采用眼部护理干预,比较两组眼部并发症发生率。结果观察组结膜充血率为4.4%,结膜暴露率为26.7%,角膜暴露率为22.2%,均明显低于对照组(P0.05)。结论对重症监护室患者实施眼部护理干预可有效降低其眼部并发症发生率,值得推广。     

重症监护室护士ICU获得性衰弱知信行的现状调查

目的了解重症监护室护士ICU获得性衰弱的知信行现状,旨在为医院开展ICU获得性衰弱相关培训提供借鉴参考。方法采用便利抽样法,于2017年12月选取新疆医科大学第一附属医院重症监护室护士180名为研究对象,采用重症监护室护士ICU获得性衰弱知信行问卷对其进行调查。结果调查的180名重症监护室护士ICU获得性衰弱知信行问卷总得分为(85.47±6.36)分,知识、态度和行为得分分别为(32.48±4.22)分、(30.48±3.42)分和(23.06±3.58)分。不同特征监护室护士ICU获得性衰弱知识、态度和行为得分比较,有统计学差异(P0.05)。重症监护室护士对ICU获得性衰弱相关知识的学习有待进一步加强。学习途径较为单一,以同事间交流、互联网和教科书为主。结论重症监护室护士ICU获得性衰弱知信行有待进一步提高,护理管理者应根据其护理队伍实际情况,创造多种可供护士学习的途径,以提高护士对ICU获得性衰弱的认知。     

机械通气病人眼部并发症的护理

分析38例重症监护室（ICU）机械通气使用镇静剂的病人的眼部并发症的原因,提出相应的护理预防措施.认为实施预见性的护理能有效减少ICU危重病人眼部并发症的发生,提高护理质量.     

Determining intensive care unit nurses' perceptions and practice levels of spiritual care in Turkey

Purpose: The purpose of this study is to determine the validity and reliability of the Turkish version of the Spiritual Care Perceptions and Practices Scale and to evaluate factors that may be effective in providing spiritual care by general intensive care unit (ICU) nurses. Background: Spiritual needs are necessary to offset spiritual deficiencies or support moral strength. During hospitalization, patients with critical conditions and their families tend to become anxious because of fear of the unknown and an uncertain future. Spiritual issues become prominent concerns for these patients and their families. Method: The data of the study were collected from a university hospital, two public hospitals and two private hospitals. A total of 170 nurses were in the ICU of these hospitals, and 123 nurses (79·4%), agreed to participate and, were included in this study. Prior to the study, an information sheet was provided to all nurses to explain the purpose and procedures of the survey. The demographic data form of ICU nurses and the Nurses' Spiritual Care Perceptions and Practices Scale were used for data collection. Results: A statistically significant difference was found between the marital status of the nurses and the total scale mean score. It was also determined that ICU nurses are in a better position regarding their perception levels of spiritual care compared to their practice levels of spiritual care, and nurses with a higher perception of spiritual care also have higher scores in the practice of spiritual care. Conclusions: ICU nurses were found to be inadequate in spiritual care practices. Study findings may be used to improve the support of nurses, to ensure sensitive spiritual care in their daily practices. Relevance to clinical practice:: ICU nurses should be aware of the importance of spiritual care and develop tools for assessing the spiritual needs of patients.     

158例农药克螨特致眼损害院前处理的调查及分析

目的了解农药克螨特致眼损害的院前处理情况。方法采用问卷和面对面访谈法，了解门诊158例农药克螨特致眼损害患者的院前处理时间、处理方式及眼损害程度。结果158例中，立即正确处理仅6例；6h内行眼冲洗40例；6h内未获冲洗者的眼损伤程度较6h内获冲洗者严重。结论农药克螨特致眼损害的院前处理正确率低，因此，需对农民加强使用农药的防护知识宣教，对基层卫生人员进行农药中毒处理的培训。     

Nursing workforce deployment and intensive care unit strain during the COVID-19 pandemic in Victoria,Australia

BackgroundThe COVID-19 pandemic demanded intensive care units (ICUs) globally to expand to meet increasing patient numbers requiring critical care. Critical care nurses were a finite resource in this challenge to meet growing patient numbers, necessitating redeployment of nursing staff to work in ICUs.ObjectiveOur aim was to describe the extent and manner by which the increased demand for ICU care during the COVID-19 pandemic was met by ICU nursing workforce expansion in the late 2021 and early 2022 in Victoria, Australia.MethodsThis is a retrospective cohort study of Victorian ICUs who contributed nursing data to the Critical Health Information System from 1 December 2021 to 11 April 2022. Bedside nursing workforce data, in categories as defined by Safer Care Victoria’s pandemic response guidelines, were analysed. The primary outcome was ‘insufficient ICU skill mix’—whenever a site had more patients needing 1:1 critical care nursing care than the mean daily number of experienced critical care nursing staff.ResultsOverall, data from 24 of the 47 Victorian ICUs were eligible for analysis. Insufficient ICU skill mix occurred on 10.3% (280/2725) days at 66.7% (16/24) of ICUs, most commonly during the peak phase from December to mid-February. The insufficient ICU skill mix was more likely to occur when there were more additional ICU beds open over the ‘business-as-usual’ number. Counterfactual analysis suggested that had there been no redeployment of staff to the ICU, reduced nursing ratios, with inability to provide 1:1 care, would have occurred on 15.2% (415/2725) days at 91.7% (22/24) ICUs.ConclusionThe redeployment of nurses into the ICU was necessary. However, despite this, at times, some ICUs had insufficient staff to cope with the number and acuity of patients. Further research is needed to examine the impact of ICU nursing models of care on patient outcomes and on nurse outcomes.     

Patient satisfaction with nursing care and its relationship with patient characteristics

The aim of this study was to assess patient satisfaction with nursing care and the relationship between patient satisfaction and patient characteristics. This cross‐sectional study was conducted at a 1100‐bed tertiary care teaching hospital in Turkey. Data were collected using the Newcastle Satisfaction with Nursing Care Scales and a patient information form. Overall, data indicated a high level of patient satisfaction. Hospitalization affected the Experience of Nursing Care Scale independently, while the type of ward, sex, income, and education independently affected the Satisfaction with Nursing Care Scale. Patients who underwent surgical procedures, male patients, the 40–59‐year‐old age group, those who had low levels of education or income, and patients who were hospitalized for long periods were most satisfied. Patients' sex, age, income, duration of hospitalization, and ward type were important factors that affected their satisfaction with nursing care. The characteristics of patients who have a low level of satisfaction with nursing care should be assessed and taken into consideration by nurses.     

福建省ICU护士对呼吸机相关性膈肌功能障碍护理知信行的现状调查

目的 了解福建省ICU护士对呼吸机相关性膈肌功能障碍(ventilator-induced diaphragm dysfunction,VIDD)护理知信行的现状,分析其影响因素.方法 采用便利抽样法,于2021年4月采用自行编制的VIDD护理知信行问卷对福建省11所三级医院的ICU护士进行问卷调查.该问卷包括知识、信...     

The relationship between nursing skill mix and severity of illness of patients admitted in Australian and New Zealand intensive care units

BackgroundCritically ill patients in the intensive care environment require an appropriate nursing workforce to improve quality of care and patient outcomes. However, limited information exists as to the relationship between severity of illness and nursing skill mix in the intensive care.ObjectiveThe aim of this study was to describe the variation in nursing skill mix across different hospital types and to determine if this was associated with severity of illness of critically ill patients admitted to adult intensive care units (ICUs) in Australia and New Zealand.Design & SettingA retrospective cohort study using the Australia and New Zealand Intensive Care Society Adult Patient Database (to provide information on patient demographics, severity of illness, and outcome) and the Critical Care Resources Registry (to provide information on annual nursing staffing levels and hospital type) from July 2014 to June 2020. Four hospital types (metropolitan, private, rural/regional, and tertiary) and three patient groups (elective surgical, emergency surgical, and medical) were examined.Main outcome measureThe main outcome measure was the proportion of critical care specialist registered nurses (RNs) expressed as a percentage of the full-time equivalent (FTE) of total RNs working within each ICU each year, as reported annually to the Critical Care Resources Registry.ResultsData were examined for 184 ICUs in Australia and New Zealand. During the 6-year study period, 770 747 patients were admitted to these ICUs. Across Australia and New Zealand, the median percentage of registered nursing FTE with a critical care qualification for each ICU (n = 184) was 59.1% (interquartile range [IQR] = 48.9–71.6). The percentage FTE of critical care specialist RNs was highest in private [63.7% (IQR = 52.6–78.2)] and tertiary ICUs [58.1% (IQR = 51.2–70.2)], followed by metropolitan ICUs [56.0% (IQR = 44.5–68.9)] with the lowest in rural/regional hospitals [55.9% (IQR = 44.9–70.0)]. In ICUs with higher percentage FTE of critical care specialist RNs, patients had higher severity of illness, most notably in tertiary and private ICUs. This relationship was persistent across all hospital types when examining subgroups of emergency surgical and medical patients and in multivariable analysis after adjusting for the type of hospital and relative percentage of each diagnostic group.ConclusionsIn Australian and New Zealand ICUs, the highest acuity patients are cared for by nursing teams with the highest percentage FTE of critical care specialist RNs. The Australian and New Zealand healthcare system has a critical care nursing workforce which scales to meet the acuity of ICU patients across Australia and New Zealand.     

Critical care nurses' perception of patient involvement in care: A qualitative focus group

Background

Patient involvement in care in the intensive care unit (ICU) is complex. Knowledge about the nature and extent of patient involvement in the Intensive care unit is scarce.

Aim

The aim of the study was to explore the critical care nursing staff's perception of patient involvement in their care in the ICU.

Study Design

A phenomenological, hermeneutic research study was carried out using qualitative data. Data were collected in two focus group interviews analysed using Ricoeur's theory of interpretation. The study was conducted in a level 2 medical-surgical 8-bed ICU in a regional hospital in Southern Denmark.

Results

Critical care nurses found it important to maintain involvement in intensive care. Depending on the patient's ability to partake in care, approaches for patient involvement ranged from (1) continually adjusting care activities according to the patient's bodily responses, (2) formation of a relationship with the patient to enable personalized care and (3) making room for self-determined care progressing with the patient's recovery.

Conclusion

Critical care nurses' perception of patient involvement depended on the patient's level of consciousness. When unconscious, patient involvement was possible but took a physical approach. However, the power inequality in the nurse–patient relationship must be expressed if patient involvement in the ICU is to take place.

Relevance to Clinical Practice

Results suggest that nurses' perception of patient involvement in the ICU depends on the patient's level of consciousness. Patient involvement may be possible even when the patient is unconscious but it takes a more physical approach. It is essential that the power inequality in the nurse–patient relationship must be expressed if patient involvement in the ICU is to take place.     

护理人员对经口气管插管口腔护理认知状况的研究

经口气管插管是救治严重呼吸衰竭患者的重要措施,为临床医生针对呼吸衰竭的各种病因治疗争取时间并创造条件,但是插管又容易引发重症监护病房(intensive care unit,ICU)重要的医院感染问题———机械通气性肺炎(ventilated associated pneu-monia,VAP)的发生。VAP是指机械通气4     

哈尔滨市ICU护士护理软技能现状的调查

目的调查哈尔滨市重症监护室（ICU）护士护理软技能现状及其影响因素。方法2011年4—7月采用整群随机抽样方法,在哈尔滨市抽取3家三甲医院ICU的护士为调查对象,采用护理软技能测评量表对300名ICU护士进行调查,评价其护理软技能情况并分析影响因素。结果共发放问卷300份,回收275份,有效问卷245份,有效回收率为89．09％。哈尔滨市ICU护士护理软技能的总均分为（145．40±15．43）分,低于全国常模。得分最高的项目为自我管理技能（43．76±4．32）分,最低得分为职业情操（26．17±2．54）分。对影响ICU护士护理软技能得分的因素进行单因素分析,发现不同年龄、性别、学历、婚姻状态、聘用形式及职称的护士软技能得分不同,差异具有统计学意义（F／t分别为13．28,6．14,4．22,6．85,2．34,5．24;P〈0．05）。以护理软技能总分为因变量,以年龄、性别、婚姻状况、学历、聘用形式、职称为自变量,进行多元线性回归分析,结果表明,护士护理软技能水平受学历、年龄、婚姻状况的影响（R。=0．202）。结论哈尔滨市ICU护士护理软技能还需进一步提高,需要对低学历、已婚及护龄长的护士进行重点干预和培训,从而改善护患关系,提高护理质量。