"云探视"在新冠肺炎疫情期间ICU探视管理中的应用

目的探讨基于微信平台的"云探视"模式在新冠肺炎疫情期间ICU探视管理中的应用效果。方法选取2020年2月1日—3月1日收治于上海市松江区中心医院ICU 82例患者及其家属作为研究对象。以2020年2月1日—15日收治的45例患者为对照组,采用传统的规定时间限制人员进入ICU探视模式;以2020年2月16日—3月1日收治的37例患者作为观察组,采用基于微信群的"云探视"模式。通过空气采样细菌培养,比较两组患者所处的ICU环境的空气质量;并于患者转出ICU的当天采用"患者家属满意度调查表"了解两组患者家属对探视的满意度情况。结果连续3 d对10间ICU病房空气培养的结果显示,两组ICU病房空气细菌培养结果均为合格,但观察组菌落数≤10 cfu/m3的房间,有30间,而对照组仅22间,且两组比较差异有统计学意义(P0.05)。同时,观察组家属满意度(93.4%)亦高于对照组(76.9%),差异有统计学意义(P0.05)。结论在新冠肺炎疫情期间,对ICU患者及家属实施"云探视"模式,有利于优化ICU病房探视流程,可有效降低ICU病房空气细菌培养总数,有助于控制医院感染及提高家属的满意度。     

ICU家属探视制度对病人及家属的影响

针对目前重症监护病房的家属探视制度从现状、原因、病人及家属的态度及需求等方面做了分析,结果显示家属探视制度对病人及家属双方的积极影响均大于消极影响,并针对病人及家属的需求提出改进方法。     

某医院急诊科患者家属新冠肺炎防治健康素养及健康教育需求调查分析

目的 调查分析某医院急诊科患者家属新型冠状病毒肺炎防治健康素养及健康教育需求.方法 选取某院在2020年2月3日-3月2日期间急诊科接诊收治的321名新型冠状病毒肺炎患者家属进行调查,利用一般问卷对所选患者家属进行一般资料及健康素养、健康教育需求的防治分析.结果 本研究一共调查321名新型冠状病毒肺炎患者家属,其中男88例,女233例;年龄以26～45岁及46～59岁为主,分别为194例和65例,分别占60.44％及12.48％;新型冠状病毒肺炎防治健康素养得分为(10.44±2.23)分,有20.87％的家属健康素养处于低水平;年龄及学历、职业与健康素养得分和健康素养水平差异具有统计学意义(P＜0.05);进行Logistic回归分析:年龄组19～25岁、26～45岁和46～59岁的健康素养水平高于≥60岁组;专科及本科学历组、硕士及以上组的健康素养水平高于初中及以下组(P＜0.05);新型冠状病毒肺炎的管理问题排在前两位的有缺乏防护物资储备和缺乏专业健康教育,分别为214人和198人,占66.67％和61.68％;新型冠状病毒肺炎的防治培训方式需求前两位:网络新闻和媒体宣传、微信等平台推送,分别为237人和236人次,占73.83％和73.52％.结论 急诊科新型冠状病毒肺炎患者家属防治健康素养水平仍然有较大的提升空间,需对老年人和低学历家属进行有效的健康认知和教育干预.     

多种形式健康宣教对PICU患儿家属选择探视方式的影响

目的 :了解PICU患儿家属对住院患儿探视方式的需求,探讨健康宣教的有效性,提高PICU患儿家属探视方式的满意度。方法:将136位患儿家属随机等分为对照组和观察组,对照组进行常规的入院宣教,观察组进行多种形式的健康宣教。设计调查问卷,宣教后调查两组患儿家属的探视需求,并在出院时进行满意度调查。结果:经过多种形式健康宣教后,两组患儿家属在限制性探视和视频探视的选择上差异有统计学意义(P0.05),对探视方式的满意度差异有统计学意义(P0.05)。结论:有效的健康宣教降低了患儿家属对限制性探视方式的需求,增加了对视频探视的需求,使家属对患儿的探视从监护室内转移到监护室外,同时有利于提高患儿家属的满意度。     

新冠肺炎疫情期间急危重症发热患者筛查病房的建立与管理

如何确保急危重症发热患者得到及时救治,又不造成交叉感染,是医院管理工作者必须思考的问题.本文详细介绍了我院设立急危重症发热患者筛查病房的方法及管理注意事项,为各医疗机构抗击新型冠状病毒肺炎疫情提供参考.     

新冠肺炎疫情期间浙江省居民焦虑抑郁现状及影响因素

目的了解新型冠状病毒肺炎疫情期间浙江省居民焦虑、抑郁的现状,并分析其影响因素。方法于2020年1月30日—2月10日,采用滚雪球抽样法选择浙江省内1 183名居民,采用自编一般情况调查表、抑郁自评量表及焦虑自评量表对其进行在线问卷调查。结果新型冠状病毒肺炎疫情期间,被调查的浙江省居民抑郁、焦虑得分为(50.93±11.58)、(47.49±12.69)分,抑郁症状阳性率为48.43%,焦虑症状阳性率为41.41%;多元线性逐步回归分析显示,影响居民抑郁的主要因素为年龄、月收入、家人最高受教育程度、自评健康状况、当地疫情情况、疫情关注度、疫情了解度及最近出门情况,影响居民焦虑的主要因素为年龄、婚姻、月收入、自评健康状况、当地疫情情况、疫情了解度、疫情管控力度及最近出门情况。结论新型冠状病毒肺炎疫情期间浙江省居民心理健康状况较差,易出现焦虑、抑郁等负性心理情绪,社区护士可针对有关影响因素开展相应的心理干预。     

26例重症型新冠肺炎患者的护理体会

总结了26例重症型(包括重型、危重型)新冠肺炎患者的护理.主要包括合理分配人力,规范护理操作,密切观察氧疗效果,注重营养支持及心理调适,尽可能降低患者死亡率,保证护理人员安全.认为重症型新冠肺炎患者死亡率高,通过提供科学的、有针对性的护理措施可为患者赢得救治时机.     

新冠肺炎疫情期间肾移植术后肺部感染患者的护理体会

观察及分析在新冠肺炎疫情期间肾移植术后肺部感染患者的防护救治措施,并进一步总结护理经验.本院于2019年12月—2020年3月收治了14例肺部感染患者,通过进行新冠肺炎与其他类型肺部感染的鉴别诊断,加强防疫监控,对症治疗等措施,为患者提供全面优质的整体护理.通过持续鉴别诊断,所有患者均非新冠肺炎患者,且预后良好,并在住...     

新型冠状病毒肺炎疫情期间心血管危重症患者的管理实践

本文总结了新型冠状病毒防疫期间心脏重症监护病房(CCU)院内防控管理实践经验,包括组建科室新型冠状病毒防控专案管理团队、CCU患者的防控管理、医务人员的防控管理等,以期为新型冠状病毒肺炎疫情防控期间CCU的感染管理提供参考。     

急诊监护室病人亲属焦虑状态调查及对策

[目的]探讨急诊监护室(EICU)病人亲属焦虑状态,为临床提供相应的护理对策.[方法]应用SAS调查表对103例EICU病人亲属的主观感觉进行评估.[结果]30%病人亲属存在焦虑症状;40岁～年龄组的女性比同年龄组男性焦虑症状严重;同性别组间比较显示,女性40岁～年龄组与其他年龄组间存在显著差异,男性20岁～组均分值在男性组中最低,且与同性别其他年龄组亦存在显著差异.[结论]对EICU病人亲属必须采取相应的心理干预措施,为其提供心理支持和疏导.     

Allied health surge capacity in Australian intensive care units during the COVID-19 pandemic: A cross-sectional survey

BackgroundBased on the early international COVID-19 experience, it was anticipated that intensive care services and workforces in Australia would be placed under similar pressure. While surge capacity of medical and nursing workforces was estimated, little was known about baseline allied health staffing, making it difficult to estimate surge capacity and coordinate planning.ObjectivesThe purpose of this study was to (i) capture baseline allied health staffing levels in Australian adult intensive care units (ICUs) prior to the COVID-19 pandemic emergence in Australia and (ii) describe the allied health pandemic planning and surge response in Australian ICUs during the early waves of the pandemic.MethodsThis was a cross-sectional, investigator-devised, prospective survey study. The survey was administered via the national chief allied health network to a convenience sample of senior ICU allied health clinicians at hospitals throughout Australia.ResultsA total of 40 responses were received from tertiary and metropolitan hospitals; 12 (30%) physiotherapists and eight (20%) occupational therapists were the most frequent respondents. Prior to the COVID-19 pandemic, 28 (70%) allied health respondents had a mean (interquartile range) of 1.74 (2.00) full-time equivalent staff designated to the ICU, where these ICUs had a mean of 21.53 (15.00) ventilator beds. Few respondents serviced their ICU on a referral-only basis and did not have dedicated ICU full-time equivalent (12; 20%). Surge planning was mostly determined by discussion within the ICU, allied health department, and/or respective disciplines. This approach meant that allied health staffing and associated decision-making was ad hoc at a local level.ConclusionsThe baseline rate of allied health coverage in Australian ICUs remains unknown, and the variability across allied health and within the specific disciplines is undetermined. Further research infrastructure to capture ICU allied health workforce data is urgently needed to guide future pandemic preparedness.     

山东省重症监护病房现状调查

目的 了解山东省重症监护病房(ICU)现状及存在的问题.方法 采用问卷调查方式,对全省二级以上医院ICU进行调查.结果 共调查了139家医院、196个ICU.①三级医院ICU中开放式管理占2.3%,半开放式管理占34.5%,封闭式管理占63.2%;二级医院ICU中开放式管理占13.7%,半开放式管理占41.3%,封闭式管理占45.0%.②床位使用率≥80%的ICU比例较高,约为49%～69%.③医师、护士与床位比例合理并达标的ICU仅占少部分,其中专职医师:床位≥1的约为13%～26%;护士:床位≥2.5的约为5%～20%.④二、三级医院的各个ICU均能良好开展基本生命支持技术,但具备调查表中16项技术的ICU则较少.结论 山东省ICU发展迅速,已初具规模,但仍有一定的欠缺,在技术项目上有较大发展空间,专业技术人员尚需进一步的规范化培训.建议重视重症医学科(综合ICU)建设,加强ICU建设管理规范及质量控制标准的落实,加强人才培养,确定准入制度,进一步发挥ICU在重症医学中的作用.     

The needs of relatives of patients admitted to intensive care units in the Trentino region

The perception of needs of relatives of patients admitted to the Coronary Care Units (CCUs) and Intensive Care Units (ICUs) of the Trentino region was investigated by interviewing 50 relatives and 72 nurses. The questionnaire used for the survey included a list of 31 potential needs of a relative. Relatives and nurses were asked to select 10 needs and rank them according to the perceived priority; the nurses were also requested to rate the level of satisfaction related to each need, on a scale from 1 to 4. The data were collected over a period of 50 days, from the end of May to the beginning of July. The priority ranking of needs by relatives was as follows: being sure that the patient receives the best possible care; that the relative could see a doctor at least once a day; and being contacted and informed on every clinically relevant change in the health-illness status of the hospitalised relative. There was a good correspondence between relatives and nurses' perceptions while no significant differences in the perception of needs was observed between relatives interviewed in CCUs and ICUs, neither between nurses with different levels of expertise. Nurses perceive that the priority needs identified by the relatives are reasonably satisfied.     

Family member perspectives on intensive care unit in-person visiting restrictions during the COVID-19 pandemic: A qualitative study

BackgroundFamily member presence in the intensive care unit is important for patient well-being and recovery. Limitations to visits increase the risk of psychological distress in family members. During the COVID-19 pandemic, in-person visiting restrictions were introduced to prevent the spread of infection.PurposeTo explore the experience of in-person visiting restrictions imposed during the pandemic on family members of patients with COVID-19 admitted to an intensive care unit.MethodQualitative method with thematic analysis. Individual semi-structured telephone interviews were conducted.FindingsWe interviewed 21 family members. The results are presented in one overall theme with two main themes and five sub-themes. The theme ‘Striving for closeness even at a distance describes the experience of being kept at a physical distance when participants needed closeness the most. Even participants who were allowed in-person visits perceived a ‘distance’ due to personal protective equipment or because they could only view the patient from a window. Participants reported that contact with and information about the patient was of utmost importance. Visits were viewed as essential in providing for the patient’s wellbeing. Meaningful contact with the ICU team was vital for getting useful information. Phone calls became a lifeline, with digital aids such as video calls used occasionally to overcome the feeling of distance.ConclusionVisiting restrictions imposed during the COVID-19 pandemic made straightforward and comprehensible communication of information from the ICU team more essential to reduce family members’ perceptions of distance and exclusion from the intensive care unit.     

Family support in intensive care units during COVID-19 visit ban: A multinational Delphi Study during first COVID-19 wave

ObjectivesThis study assessed opinions and experiences of healthcare professionals, former patients and family members during the first wave of the COVID-19 pandemic and focuses on challenges in family-centred care for intensive care unit patients and affected families.Research methodology/DesignA two-round modified Delphi process assessed the opinions and experiences of experts such as healthcare professionals, former patients and their families (n = 151).SettingThis study was conducted across four countries in Europe.ResultsIn total, 121 participants (response rate 80.13%) answered the first Delphi round; the second was answered by 131 participants (response rate 86.75%). Participants perceived family support in the intensive care unit as highly important during the COVID-19 pandemic. Enabling contact amongst patients, families and clinicians is regarded as essential to build hope and confidence in the treatment and the recovery process. The extraordinary situation led to the implementation of new communication structures such as video calls and websites.ConclusionA consensus was reached between healthcare professionals that virtual contact is essential for patients with COVID-19 and their families during visit restrictions. This should be done to establish confidence in the treatment.