ICU转出患者肺部护理计划的实施及效果评价

目的 降低外科术后患者因肺部感染非计划重返ICU率。 方法 成立ICU转出患者肺部护理小组,参照多学科围手术期气道管理中国专家共识（2018版）,通过评估ICU转出患者肺部高危因素,制订和落实个体化肺部护理计划,建立实施过程风险排查机制,基于气道分级管理标准进行转出前后肺部护理效果评价及质量控制共计5个关键流程。比较改进前（对照组）、改进后（试验组）患者因肺部感染重返ICU率,以及肺部护理干预频次和患者满意度。 结果 试验组和对照组发生因肺部感染重返ICU率分别为0%和11.06%,差异具有统计学意义（P<0.01）;试验组各项肺部护理措施的干预频次多于对照组,差异均具有统计学意义（均P<0.01）;试验组满意度高于对照组,差异具有统计学意义（P<0.01）。 结论 通过ICU转出患者肺部延伸护理计划的实施,为ICU转入普通病房的过渡期患者提供持续的肺部管理,可降低重返ICU率并提高患者的就医体验。

Implementation and effect evaluation of pulmonary extension nursing plan for patients transferred out of ICU

Objective To reduce the unplanned ICU readmission rate of patients due to pulmonary infection after surgery. Methods We established ICU-ward extension nursing team. With reference to the expert consensus on multidisciplinary perioperative airway management in China（2018 edition）,through lung assessment of high risk factors among patients transferred out of ICU,individualized pulmonary nursing plan was formed,specialized and systematic lung care was performed,procedure risk screening mechanism was established and implemented. Based on standard airway grading management,effect evaluation and quality control of pulmonary nursing from four aspects were performed before and after transfer to ensure effects of extension nursing,and reduce ICU readmission rate due to pulmonary infection. Results The ICU readmission rate due to pulmonary infection in the experimental group and the control group were 0% and 11.06%,respectively. Conclusion Through the implementation of pulmonary extension nursing plan for patients transferred out of ICU,we can provide continuous lung management for patients transferred to the general ward,reduce ICU readmission rate,and achieve nursing goals of improving clinical indicators and patient experience.