ICU死亡患者监护、死亡时间的回顾性分析及护理对策

Retrospective analysis of monitoring of death patients and the time of death and nursing countermeasures in ICU

目的 分析ICU死亡患者的监护时间,探索监护时间的影响因素,并提出护理对策.分析患者的死亡时间分布,预见性地做好救护防范措施.方法 对2011年7月至2012年7月ICU病房52例死亡患者的病史资料进行回顾性分析.结果 特护时间≤1d、特护时间2～7d以及特护时间＞7d的3组患者院内感染发生率及病死率比较差异有统计学意义（x2 =6.741,P＜0.05）.特护时间越长,院感发生率越高.白班与夜班病死人数差异无统计学意义（P＞0.05）,但死亡时间集中于各班交班后的2h内.结论 管理者应积极主动采取有效措施,预防院内感染的发生.规范ICU准入与准出标准,控制ICU患者停留时间,从而降低感染率与死亡率.本研究中患者死亡时间在交接班时间段呈集中趋势,应采取相应的治疗护理对策,加大护理力度,及时发现病情变化,减少患者死亡.

Objective To analyze the ICU death patient monitoring time, to explore the impact factors of time monitoring and put forward nursing countermeasures; To analyze the distribution of death time of the patients and make preventive measures. Methods The medical history and the data of 52 death patients from July 2011 to July 2012 were retrospectively analyzed. Results The incidence and mortality of nosocomial infection in the three groups patients including intensive care time ~〈 I day, from 2 to 7 days and I〉7 days were different, and the difference was statistically significant （X2 = 6. 741, P 〈 0.05 ）. The longer intensive care time, the higher incidence and mortality of nosocomial infection. The death cases were similar in the day shift and night shift, and the difference was not statistically significant （P 〉 0.05）. The time of death focus on each class after hand-over 2 hours. Conclusions Managers should take effective measures to prevent the occurrence of nosocomial infection. To standardize access and exit in ICU and to control the residence time of ICU patients, so as to reduce the infection and mortality. In this study, the time of death was concentrated in the shift time, managers should take corresponding nursing countermeasures, increase the force of nursing, timely detect changes in condition, so as to reduce the patients＇ death.