风险评估引导下分级护理对重症监护室心脏手术患者获得性谵妄的预防效果分析与探讨

Analysis and Discussion of the Effect of Risk Assessment-guided Graded Care on the Prevention of Acquired Delirium in Cardiac Surgery Patients in the Intensive Care Unit

目的:分析对于重症监护室(ICU)心脏手术患者采用基于风险评估的分级护理模式对于预防术后获得性谵妄发生的临床价值。方法:样本抽取时间为2021年1月—2023年12月,地点为南京市第一医院ICU,均为心脏手术患者,样本数量260例,通过随机数字表法分组,即对照组和观察组,各组病例数量均为130例,对照组患者采用常规护理,观察组在此基础上联合运用基于风险评估的分级护理,对于两组患者术后获得性谵妄的发生率、谵妄持续时间、住院时间以及护理满意度等进行比较。结果:与对照组进行组间对比,术后获得性谵妄发生率为观察组较低,且观察组谵妄患者的持续时间短于对照组(P<0.05);与对照组进行组间对比,ICU住院时间以及总住院时间均为观察组较短(P<0.05);护理满意度组间对比中,观察组99.23%,对照组88.46%,P<0.05。结论:对于ICU心脏手术患者采用基于风险评估的分级护理模式可以有效预防术后的获得性谵妄,并可缩短患者的住院时间、和谐护患关系。

Objective:To analyze the clinical value of adopting a graded care model based on risk assessment to prevent the occurrence of postoperative acquired delirium in patients undergoing cardiac surgery in the intensive care unit(ICU).Methods:The sample was taken from January 2021 to December 2023 in the ICU of Nanjing First Hospital,all of which were cardiac surgery patients,with a sample size of two hundred and sixty cases,which were grouped into two groups,i.e.,the control group and the observation group,with the number of cases in each group being one hundred and thirty cases,by means of a randomized table method.The patients in the control group adopted conventional nursing care,and the observation group jointly utilized risk assessment-based graded nursing care on this basis.The incidence of postoperative acquired delirium,duration of delirium,hospitalization time,and nursing satisfaction were compared between the two groups.Results:Comparing with the control group,the incidence of postoperative acquired delirium was lower in the observation group(P<0.05),and the duration of delirium in the observation group was shorter than that in the control group(P<0.05);comparing with the control group,the length of stay in the ICU and the total hospitalization time were shorter in the observation group,(P<0.05);in the between-group comparison of nursing satisfaction,99.23%in the observation group and 88.46%in the control group(P<0.05).Conclusion:Adopting a graded care model based on risk assessment for cardiac surgery patients in ICU can effectively prevent postoperative acquired delirium,shorten the hospitalization time of patients,and harmonize the nurse-patient relationship.