ICU夜间噪声管理对患者谵妄发生率的影响

Effects of ICU nighttime noise management on the incidence of delirium in patients

目的探讨ICU夜间噪声管理措施对ICU夜间噪声、患者睡眠质量以及谵妄发生率的影响,为临床护理人员提供借鉴。方法哈尔滨市某三甲医院ICU从2017年1月起实施夜间噪声综合管理措施,实施前(2016年10-12月)纳入患者82例,实施后(2017年2-4月)纳入患者78例,比较噪声管理措施实施前后ICU夜间噪声情况、患者睡眠质量和谵妄的发生率。结果实施前ICU夜间噪声等效声级为(58.34±6.21)dB,实施夜间噪声管理措施后为(46.33±4.17)dB,差异有统计学意义(t=15.139,P<0.05)。实施后患者睡眠质量得分(72.9±2.9)分,高于实施前;镇静药物用量(67.6±6.3)mg,低于实施前,差异均有统计学意义(t值分别为-20.476、13.285;P<0.05)。实施前患者谵妄发生率51.3%,实施后为29.3%,差异有统计学意义(χ^2=5.403,P<0.05)。结论在ICU病房进行夜间噪声管理措施,降低病房夜间噪声的同时,有助于改善患者睡眠质量,降低患者谵妄的发生率,对提高护理效果具有重要意义。

Objective To explore the effects of ICU night noise management on ICU nighttime noise,patient sleep quality and delirium incidence.Methods ICU of a Class Ⅲ Grade A hospital in Harbin has implemented comprehensive noise management measures since January 2017.A total of 82 patients were recruited before implementation (October to December 2016),and 78patients were recruited after implementation (February to April 2017).ICU nighttime noise,patient sleep quality and delirium incidencewere compared after the implementation of ICU nighttime noise management.Results The equivalent sound level of ICU nighttime noise was (58.34±6.21)dB before the implementation of nocturnal noise management and (46.33±4.17)dB after the implementation,and the difference was statistically significant (t=15.139,P <0.05). The sleep quality was (72.9±2.9)after the intervention,which was higher than before.The amount of sedative drugs was (67.6±6.3)mg,which was lower than before.The differences were statistically significant (t=-20.476, 13.285;P <0.05).The incidence of delirium in patients was before and after intervention was 51.3% and 29.3% respectively,and the difference was statistically significant (χ^2=5-403,P <0.05).Conclusions Noise management measures at night in ICU ward can reduce noise at night,improve sleep quality and reduce the incidence of delirium.It is of great significance to improve nursing effect.