护理活动评估量表在ICU护理工作量调查中的应用

[目的]应用护理活动评估量表评估ICU护理工作量,为护理管理者合理安排护士人力提供理论依据。[方法]翻译英文版护理活动评估量表,评价其信度及效度;并应用此表对2006年1月—4月入住中国医科大学附属第一医院ICU病人进行护理工作量评价。[结果]ICU病人不同住院时期、不同转归对护理工作量有影响,而不同疾病种类间护理工作量差异无统计学意义。[结论]护理活动评估量表在ICU的应用可以反映ICU的护理工作量情况,并能为合理地调配ICU护士人力提供有价值的数据支持。     

护理活动评估量表在ICU护理工作量调查中的应用

[目的]应用护理活动评估量表评估ICU护理工作量,为护理管理者合理安排护士人力提供理论依据.[方法]翻译英文版护理活动评估量表,评价其信度及效度;并应用此表对2006年1月-4月入住中国医科大学附属第一医院ICU病人进行护理工作量评价.[结果]ICU病人不同住院时期、不同转归对护理工作量有影响,而不同疾病种类间护理工作量差异无统计学意义.[结论]护理活动评估量表在ICU的应用可以反映ICU的护理工作量情况,并能为合理地调配ICU护士人力提供有价值的数据支持.     

神经外科重症监护病房护理工作量的调查分析

目的 对神经外科重症监护病房(NCU)的护理工作量进行调查,根据工作量计算护士人数,并预见性地合理安排每班护士人数,提高护理效果.方法 运用护理活动评估量表(NAS)对住院患者每天的护理工作量和病区总的护理工作量进行评价研究,分析影响护理工作量的相关因素.结果 NCU患者当天需要的护理工作量得分为30.23～ 87.6分,平均54.39分.护理工作量与患者入住NCU的时间、不同转归情况及是否手术有关.结论 NCU护理人员处于缺编状态,护士已达到超负荷工作状态.NCU护士人力应以所收治患者实际需要的护理工作量进行动态合理分配.采用护理活动评分系统进行人力资源管理可提高NCU护理质量.     

应用护理活动量表对不同医院ICU护理工作量的研究

[目的]了解ICU护士工作负荷状态。[方法]应用护理活动量表(NAS)测量2011年7月—2011年9月自贡市第一人民医院ICU和第三人民医院ICU护理工作量。[结果]周一至周日每天总的护理工作量比较和周一至周日每天人均护理工作比较,差异无统计学意义;不同班次护士的人均护理工作量比较,差异有统计学意义(P<0.01)。[结论]本调查的两所医院ICU护理工作量无平常日与周末的区别,护理人员的排班均衡到每一天,但是各班护理人员不均衡,中午、夜间护士处于超负荷工作状态。建议加强中午、夜间护理人力。     

体外循环术后患者重症监护工作量的调查分析

目的调查患者体外循环术后各天、各班次平均重症监护所需的直接和间接护理时数,以合理配置护理患者所需的人力资源.方法随机抽取重症监护室体外循环术后患者58例,记录患者术后各天、各班次所需直接及间接护理时数并进行统计学分析.结果体外循环术后患者各天重症监护所需直接、间接、总护理时间随着术后天数的增加减少;各班平均每小时护理时间比较,日班与前夜班、日班与后夜班之间直接、间接、总护理时间差异均有统计学意义(P＜0.05).结论体外循环术后患者各天及各班次所需的护理时间不同,护理管理者应根据患者术后的情况采取弹性排班.     

儿童心脏中心重症监护室护理能级管理的实践

目的探讨能级管理在儿童心脏中心重症监护室中的应用效果。方法将儿童心脏中心重症监护室30名护士划分为N_0~N_4共5个层级12个等级,制订各层级岗位职责,实施能级管理。比较能级管理前后患儿康复指标、护士专科护理技术合格率及医、护和患儿家属对ICU护理工作满意度。结果能级管理后,患儿各项康复指标好转(P0.05),护士专科护理技术合格率差异无统计学意义(P=0.225),医生、患儿家属以及护士自身的满意度均提升(P0.01)。结论儿童心脏中心重症监护室开展护理能级管理,可促进患儿康复,提升医、护和患儿家属对护理工作的满意度。     

心血管内科重症监护室护理分级评分量表的设计与应用体会

成立重症监护室(CCU)护理分级评分量表编制专家小组,借鉴芬兰护理学家Pyykko等于2000年提出的重症监护护理评分系统(ICNSS),自行设计CCU护理分级评分量表,制定量表条目、结构及评分方法,并用其对CCU住院的406例患者进行临床试验性应用。406例患者中,需提供1级预防性护理的患者数为0,2级支持性护理110例,占27%;3级补偿、缓解性护理216例,占53%;4级代偿、救助性护理80例,占20%。CCU护理分级评分量表是以护理问题为依据,以护理干预措施为指导的护理分级的测量工具,评分方法简便,对护理工作可起到一定的指导作用。     

重症监护信息系统在ICU护理中的应用分析

目的研究探讨重症监护信息系统在重症监护病房(intensive care unit,ICU)护理中的应用效果。方法随机选择我院ICU 2018年1～6月、2018年7～12月收治的重症患者各40例进行回顾性研究,分别设置为对照组、观察组,对照组实施常规护理,观察组护理中应用重症监护信息系统,比较两组每日护理事件耗时、护理事件差错频率、ICU治疗时间、住院时间、舒适度评分、不良情绪评分、护理满意度。结果 (1)观察组每日病情记录、观察项维护、出入量维护、医嘱核对等护理事件耗时均较对照组缩短,其各项护理事件差错频率均较对照组降低(P0.05)。(2)观察组ICU治疗时间、住院时间均较对照组缩短(P0.05)。(3)护理后,观察组的舒适度评分较对照组更高,其不良情绪各评分均较对照组更低(P0.05)。(4)护理总满意率分别为95.00%(观察组)、80.00%(对照组),观察组较对照组更高(P0.05)。结论重症监护信息系统的应用有效提高了ICU护理效率和护理质量,减少了护理差错发生,有利于缩短患者治疗时长,提高其舒适度,减轻其不良情绪,使其更加满意。     

ICU患者早期离床活动的护理研究进展

重症监护病房患者由于长时间卧床、不适当的约束及深度镇静导致肌力的快速丧失,出现一系列严重的并发症,严重影响患者生活质量、功能康复及回归社会的能力。随着重症医学的不断发展,医护人员对危重患者进行早期离床活动的了解更加深入。患者入院后不久在可行的条件下提倡早期离床活动对于患者来说是安全、可行的,甚至是改善患者预后的一项有效策略。目前,国内外就ICU患者早期离床活动做了多方面研究,但在具体实践中却困难重重,效果并不理想。本文介绍了早期离床活动的必要性及活动时机、早期离床活动实施方案、早期离床活动的影响因素及策略方面,对早期离床活动应用于危重症患者中的护理研究展开综述。     

ICU病房实施人性化优质护理的体会

我科是我们县区第一家ICU病房,2010-05投入使用,设施配备比较先进,护士整体素质较高.自开科以来,我们根据卫生部优质护理服务示范工程活动方案,本着为人民群众提供安全、优质、满意的护理服务为出发点.在ICU病房实施人性化的优质护理,收到较好的效果,现总结如下.1加强管理,树立以人为本的理念人性化护理是以尊重患者的生命价值、人格、尊严和个人隐私为核心,为患者营造一个舒适的就医环境,患者在就医全过程中感到方便、舒适和满意的一种护理方法[1].传统的护理模式护士偏重于完成治疗任务,忽视患者的基础生活护理等.     

The characterisation of workloads and nursing staff allocation in intensive care units: A descriptive study using the Nursing Activities Score for the first time in Norway

Objective

This study compares the Nine Equivalents of Nursing Manpower Use Score (NEMS) to the Nursing Activities Score (NAS) in terms of characterising the nursing workload by examining and calculating the per-nurse NAS% over a 24-h period.

Method

The sample consisted of 235 patients from four volunteered for the study multidisciplinary ICUs in Norway. The daily NEMS, NAS and number of nurses who were involved in patient care per ICU were measured over one month from 2008 to 2009.

Results

The average length of stay for the included patients was 5 days, and the mean patient age was 52.8 years. The mean NEMS was 32.7 points (S.D., 8.98 points), and the mean NAS was 96.24% (S.D., 22.35%). Several nurses exhibited mean NEMS points that ranged from 16 to 39.7 per ICU per day. The correlation between the NEMS and NAS could only be separately determined for each ICU. The correlation was r = 0.16–0.40 [significant at the 0.01 level (2-tailed)] per unit. Depending on which unit was investigated, each nurse was observed to perform of capacity with a NAS as high as 75–90%.

Conclusion

The study suggests that the actual numbers of nurses might explain the calculated NAS of 75–90% per nurse.     

The reliability and validity of the therapeutic activity index

PURPOSE: To assess the psychometric properties of the Simplified Therapeutic Intervention Scoring System (TISS 28) scale. MATERIALS AND METHODS: A prospective observational design was used. Patients were recruited from a medical-surgical intensive care unit (ICU) and 4 rehabilitation wards of 2 university-affiliated hospitals in Hong Kong. RESULTS: Data necessary for the calculation of the TISS 28, the Therapeutic Intervention Scoring System (TISS 76), and severity of illness scoring system (Simplified Acute Physiology Score [SAPS II]) were recorded for each patient during the first 24 hours after his/her admission to an ICU. A significant positive correlation was found between the TISS 76 and the TISS 28 scores as well as the TISS 28 and the SAPS II scores. There was a significant difference between the TISS 28 scores among ICU patients and patients in rehabilitation wards. A significant correlation was found between the TISS 28 scores of the first and second set of TISS 28 scores. CONCLUSIONS: Although the findings supported the validity and reliability of the TISS 28, there were limitations of the TISS 28 in measuring nursing workload in ICUs. Hence, continued amendment and validation of the TISS 28 on larger samples in different ICUs would be required so as to provide clinical nurses with a valid and reliable assessment of nursing workload.     

A profile of european ICU nursing

Objective: To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. Design: A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to be passed on to the nurse-in-charge of their ICU. Results: 156 completed questionnaires were analyzed: 49 % were from university hospitals, 26 % from university-affiliated hospitals, and 25 % from community hospitals; 42 % of the hospitals had more than 700 beds, 67 % of the ICUs had between 6 and 12 beds, and 54 % were mixed medical–surgical units. Among British units, 79 % had more than three full-time nursing equivalents (FTE) per ICU bed, while in Sweden 75 % of units had less than two FTE/ICU bed. University hospitals had more nursing staff per bed than community hospitals. As regards training, 33 % of nurses followed a training course before starting work on the ICU and 64 % after starting on the unit, and 85 % had easy access to continuing education, particularly in the university hospitals. In an emergency, more than 70 % of nurses regularly initiated oxygen administration, mask ventilation, or cardiac massage. In Sweden 100 % of nurses and in Switzerland 91 % of nurses regularly inserted peripheral intravenous catheters, but only 7 % of German nurses did. No German nurses and only 12 % of British nurses regularly performed arterial puncture, but in Sweden 75 % of nurses regularly did. Conclusion: Even though the number of participants were limited, our questionnaire revealed variations in nurse staffing patterns among European countries and in their systems of training and education. Nurse autonomy also varies widely between countries. Received: 30 July 1997 Accepted: 22 May 1998     

133例大面积烧伤患者护理时数影响因素分析

目的探讨大面积烧伤患者伤后早期护理工作量的影响因素,为战时一线医院烧伤病房护理人力配备提供借鉴。方法统计2000年1月至2006年3月在某全军烧伤中心住院治疗的133例大面积烧伤患者伤后5d内的护理时数,多因素逐步回归分析大面积烧伤患者护理时数最重要的影响因素。结果大面积烧伤患者第1天护理时数分值与其后4d差异显著(P<0.001);烧伤面积、吸入性损伤、头面烧伤、致伤因子是大面积烧伤患者伤后早期护理时数最重要的影响因素,且与其正性相关。结论大面积烧伤患者入院5d内以第1天护理工作量最大,其后逐步递减;其中烧伤面积大、有头面部烧伤或吸入性损伤者护理工作量大,且不同的致伤因素可导致护理工作量不同;护理管理者在配备护理人力时应予充分考虑。