基于MEWS的分级责任制护理在重症监护室急性肾损伤患者护理中的应用效果

Intervention effect of MEWS-based hierarchical accountability nursing in the care of patients with acute kidney injury in the intensive care unit

目的探讨基于改良早期预警评分系统(MEWS)的分级责任制护理在重症监护室(ICU)急性肾损伤患者护理中的应用效果。方法选择2018年2月-2019年3月河南省某医院收治的急性肾损伤患者40例设为对照组;选择2019年4月-2020年5月河南省某医院收治的急性肾损伤患者40例设为干预组。对照组患者行常规ICU护理干预,干预组患者在对照组基础上行基于MEWS的分级责任制护理干预。比较2组患者总抢救时间、ICU住院时间、总住院时间;比较2组患者干预前及干预7 d时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分。比较2组患者护理满意度。结果干预组患者总抢救时间、ICU住院时间、总住院时间短于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者APACHEⅡ、HAMA、HAMD评分比较,差异无统计学意义(P>0.05)。干预后,2组患者APACHEⅡ、HAMA、HAMD评分均低于干预前,且干预组低于对照组,差异均有统计学意义(P<0.05)。干预组患者护理总满意度为97.50%,高于对照组的80.00%,差异有统计学意义(P<0.05)。结论ICU急性肾损伤患者接受基于MEWS的分级责任制护理干预的效果显著,该干预方式缩短了总抢救时间、ICU住院时间、总住院时间,减轻了患者病情严重程度,改善了患者心理状态,并提高了患者护理满意度。

Objective To explore the intervention effect of hierarchal accountability nursing based on the modified early warning scoring(MEWS)system in the care of patients with acute kidney injury in the intensive care unit(ICU).Methods Forty patients with acute kidney injury admittecl to a hospital in Henan province from February 2018 to March 2019 were selected as the study subjects and set as the control group;40 patients with acute kidney injury admittecl to a hospital in Henan province from April 2019 to May 2020 were selected as the study subjects and set as the intervention group.Patients in the control group underwent conventional ICU nursing interventions,and patients in the intervention group underwent MEWS-based hierarchical accountability nursing interventions on the basis of the control group.The total resuscitation time,length of stay at ICU,and total length of stay of the patients in the two groups were compared;the scores of the acute physiology and chronic health evaluation II(APACHEⅡ),hamilton anxiety scale(HAMA),and hamilton depression scale(HAMD)before and at 7 d of the intervention were compared between the two groups.Patient satisfaction with care was compared between the 2 groups.Results The total resuscitation time,ICU stay and total hospital stay of patients in the intervention group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before the intervention,there was no statistically significant difference between the APACHEⅡ,HAMA and HAMD scores of patients in the 2 groups(P>0.05).After the intervention,the APACHEⅡ,HAMA and HAMD scores of patients in the 2 groups were lower than before the intervention,and the intervention group was lower than the control group,and the differences were statistically significant(P<0.05).The total nursing satisfaction of patients in the intervention group was 97.50%,which was higher than that of 80.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of ICU patients with acute kidney injury receiving MEWS-based hierarchical accountability nursing intervention was significant.This intervention shortened the total resuscitation time,ICU stay,and total hospital stay,reduced the severity of patients'conditions,improved patients'psychological status,and increased patients'nursing satisfaction.