ICU病人的院内安全转运

通过 171例ICU病人院内转运情况分析 ,探讨安全进行重症病人院内转运的措施。包括转运前权衡与意外估计 ,与接收部门的协作 ,转运前病人准备、仪器选择、人员选择 ,转运过程中监测 ,转运中的记录等。     

昏迷病人ICU管理

昏迷病人的管理,一直是比较繁重和困难的。而ICU的建立,为昏迷病人的管理提供了理想的环境和全方位的监控,使病人的生存率有了进一步的提高。我院综合性ICU从1991年1月～1992年10月共收治     

综合性医院ICU护理工作满意度调查

目的探讨影响ICU护理工作满意度的因素及对策。方法随机对110例出院患者及其家属对护理工作满意度进行问卷调查。结果 ICU护理工作满意度普遍低于全院综合护理满意度。结论 ICU护士应不断提高专业知识,加强自身的文化教育,更新服务理念,建立以人为中心的服务模式,加强ICU护理支持。     

ICU应用重症病人评估积分单的做法与体会

为了准确地对重症病人实施评价和护理,我院参照美国ＡＰＡＣＨＥ系统评分和加拿大ＰＲＮ护理管理工作法,制定了“重危病人评估积分单”,它包括１２项生理参数积分,年龄积分,意识积分,脏器衰竭程度积分,护理工作量积分五项,其中前四项评估患者的病情,后一项评估该病人所需的护理工作量,五项评估的总分是对患者情况综合、客观的描述,表明其病情及所需工作量的大小程度。利用这个评估单评估一级护理以上的危重患者,为管理者提供科学指导和质量监控,效果良好。 ＩＣＵ的病人均为普通科室内需要特别护理的危重患者,存在多系统功能…     

手术室病人家属需求的调查分析

目的 了解病人在接受手术时，其家属对各方面的需求。方法应用自制的“手术病人家属需求调查表”对60例家属进行了调查。结果家属要求我们保证病人的安全，要求我们技术过硬、服务态度好；希望手术室外有咖啡厅样的等候环境，有配套的洗手间，能获得术后照护知识。结论我们必须提高自身素质，做好健康宣教工作，切实改变环境，满足家属需求，以帮助病人及家属度过难关，维持病人及家属的身心健康。     

ICU病人临终关怀护理95例体会

【目的】探讨护士如何在重症监护病房进行临终护理,以便更好地实施人性化护理。【方法】按医院制定的临终关怀护理手册培训后,护士在ICU病房按规范对95例临终病人家属实施关怀护理。【结果】95例临终病人家属接受关怀后,均对护理感到满意。【结论】对护士实行临终关怀培训和指导,将人文关怀护理理念融入护理工作中,有利于提高护士的关护行为技巧和病人家属对护理工作的满意度。     

ICU患者家属需求调查分析

目的了解重症监护病房(ICU)患者家属的需求状况,为维持ICU患者家属的身心健康提供依据。方法应用中文版CCFNI量表,对2所三级甲等综合医院ICU收治的70例患者家属进行问卷调查。结果 ICU患者家属需求的重要性程度由高至低依次为病情保证、获取信息、亲近患者的需求、医护人员支持、家属自身的舒适。除了婚姻状况,患者家属的一般情况与家属需求无显著性差异。结论护士应了解患者家属的需求,以达到满足患者家属需求的目的 。     

Optimal occupancy in the ICU: A literature review

IntroductionIn intensive care, occupancy is a commonly used measure. There is inconsistency however in its measurement and optimal occupancy targets need to be defined. The objectives of this literature review were to explore how occupancy is measured, reported, and interpreted and investigate optimal occupancy levels for ICUs.MethodA literature search was performed using the Medline, Embase and CINAHL databases and citation tracking identified additional relevant articles. Articles published since 1997, written in English and focused on the adult ICU setting were included. As a result, 16 articles were selected for this review.ResultsAlthough it was apparent there was no commonly accepted or used method for calculating ICU occupancy, methods described as more accurate enumerate actual patient hours in the ICU, use operational (and preferably fully staffed) beds as the denominator, and are calculated daily. Issues pertaining to the utility, interpretation, and reporting of ICU occupancy measures were identified and there were indications that optimal ICU occupancy rates were around 70–75%. It was evident however that setting a uniform target figure for all ICUs would be problematic as there are a range of factors both at the unit and the hospital level that impact occupancy figures and optimal occupancy levels.ImplicationsThis literature review informed the recommendation of a proposed method for calculating ICU occupancy which provides a realistic measure of occupied bed hours as a percentage of available beds. Despite the importance of gaining an understanding of ICU occupancy at the local and broader health system levels, there are a number of unknown factors that require further research. Appropriate occupancy targets, impact of unavailable beds, and the intrinsic and extrinsic factors on occupancy measurement are a few examples of where more information is required to adequately inform ICU monitoring, planning and evaluation activities.     

SLEEP-MAD模式改善ICU患者睡眠障碍的应用效果分析

目的探讨改善ICU患者睡眠质量的标准化结构方法SLEEP-MAD模式护理策略的效果。方法采用便利抽样法,将2018年7月1日—2019年6月30日入住山西白求恩医院山西医学科学院ICU的睡眠障碍患者共180例纳入研究,其中对照组为2018年7月1日—12月31日入住ICU的患者(85例)。观察组为2019年1月1日—6月30日入住ICU的患者(95例)。对照组给予常规的睡眠管理,观察组按照SLEEP-MAD模式要求进行集束化干预管理,采用中文版理查兹—坎贝尔睡眠量表(RCSQ)进行睡眠质量的评估及相关因素的资料收集,通过统计结果对应用效果进行分析说明。结果干预前,两组患者RCSQ各维度得分比较,差异无统计学意义(P>0.05);干预后,观察组患者各维度得分均高于对照组,除再入睡维度外,其余维度两组得分比较差异有统计学意义(P<0.05)。结论睡眠质量的标准化结构方法SLEEP-MAD模式应用于ICU睡眠障碍患者的护理,可以有效地提高患者的应对水平,提高和改善睡眠质量。     

基于循证理论与“知识-行动”模型的电子护理交接单在ICU患者中的应用

目的探讨基于知识-行动(KTA)框架和循证的电子护理交接单在ICU患者中的应用。方法采用便利抽样法,选取2018年6月—2019年5月郑州大学第一附属医院的122例ICU患者为研究对象。在KTA框架的指导下,设计基于ISBAR沟通标准工具的电子化护理交接单。将122例ICU患者分为对照组(n=62)和干预组(n=60),对照组采取传统交接形式,干预组采用电子护理交接单,比较两组责任护士交接班质量和满意度。结果干预组患者交接时间为(2.78±1.12)min,对照组为(6.52±1.45)min,两组比较差异有统计学意义(P<0.05);干预组交接班漏项发生率3.33%(2/60),护理风险事件发生率为0,均低于对照组,两组比较差异均有统计学意义(P<0.05)。干预组患者的护理交接班质量总分(69.75±12.86)分,对照组为(58.68±9.87)分,两组比较差异有统计学意义(P<0.05)。结论基于“知识到行动”框架和循证的电子护理交接单应用于ICU患者,可改善护理交接质量,提高护理质量,值得临床推广。     

万古霉素治疗重症监护病房革兰阳性菌感染的研究进展

革兰阳性菌是ICU最为重要的致病菌之一,万古霉素作为一线用药对其感染疗效肯定。近期指南推荐的万古霉素血药浓度在临床应用较为广泛,但临床医师对增高的谷浓度所面临的不良反应(主要为肾功能损害)仍十分关注。现就万古霉素及其在急、危重症患者等特殊群体中药代/药效动力学,治疗方案的调整和相关肾损伤等方面予以综述。     

Managing anxiety in ICU patients: the role of pre-operative information provision

Hospital-induced patient anxiety and coping mechanisms are discussed. The value of giving pre-operative information to reduce anxiety in elective admissions to intensive care unit is discussed. Recommendations are given based on the literature evidence to aid service and practice development.     

A family intervention to reduce delirium in hospitalised ICU patients: A feasibility randomised controlled trial

BackgroundFamily members could play an important role in preventing and reducing the development of delirium in Intensive Care Units (ICU) patients. This study sought to assess the feasibility of design and recruitment, and acceptability for family members and nurses of a family delivered intervention to reduce delirium in ICU patients.MethodA single centre randomised controlled trial in an Australian medical/surgical ICU was conducted. Sixty-one family members were randomised (29 in intervention and 32 in non-intervention group). Following instructions, the intervention comprised the family members providing orientation or memory clues (family photographs, orientation to surroundings) to their relative each day. In addition, family members conducted sensory checks (vision and hearing with glasses and hearing aids); and therapeutic or cognitive stimulation (discussing family life, reminiscing) daily. Eleven ICU nurses were interviewed to gain insight into the feasibility and acceptability of implementing the intervention from their perspective.ResultsRecruitment rate was 28% of eligible patients (recruited n = 90, attrition n = 1). Following instruction by the research nurse the family member delivered the intervention which was assessed to be feasible and acceptable by family members and nurses. Protocol adherence could be improved with alternative data collection methods. Nurses considered the activities acceptable.ConclusionThe study was able to recruit, randomise and retain family member participants. Further strategies are required to assess intervention fidelity and improve data collection.     

应用护理活动评估量表对ICU护理工作量的调查与分析

目的应用护理活动评估量表(NAS)评价ICU护理工作量,分析ICU护理工作量特征,为护理管理者合理配置人力资源提供依据。方法翻译英文版NAS,评价其信度、效度及文化相关性。2006年1～4月,对所有入住中国医科大学附属第一医院ICU的病人,应用NAS评价护理工作量。结果该院ICU病人因入住ICU时间不同、转归不同,其护理工作量也不同,并与疾病种类无关。结论中文版护理工作量评估表是一种具有较高信度和效度的ICU专用护理工作量评估量表,可以为护理管理者提供可靠的理论依据和数据支持。