ICU危重患者意外拔管原因及护理干预效果分析

Analysis on the causes of accidental extubation and the effect of nursing intervention in ICU critically ill patients

目的分析重症加强护理病房(ICU)危重患者意外拔管发生原因,并探讨护理干预应用效果。方法选取2014年1月~2017年3月ICU接收的262例危重患者为研究对象,以循证护理为分界点,将其分为两组。常规护理组(n=128)给予基础护理配合,循证护理组(n=134)根据意外拔管发生原因进行循证护理干预。比较两组患者意外拔管发生率、夜间高危时段意外拔管发生率以及护理满意度。结果循证护理组患者意外拔管发生率为1.49%(2/134),夜间高危时段发生率为0.75%(1/134),常规护理组意外拔管发生率为11.72%(15/128),夜间高危时段发生率为6.25%(8/128),差异有统计学意义(P<0.05)。循证护理组满意度为93.28%(125/134),常规护理组为79.69%(102/128),差异有统计学意义(P<0.05)。结论以循证护理理念服务模式应用于ICU危重患者护理有助于控制意外拔管风险事件,提高患者生存质量及护理满意度,值得推广。

Objective To analyze the causes of accidental extubation in critically ill patients in the intensive care unit （ICU）, and to explore the application effect of nursing intervention. Methods A total of 262 critically ill patients who were admitted to ICU from January 2014 to March 2017 were selected as study subjects. The evidence-based nursing was selected as the dividing point, and the patients were divided into two groups. Routine nursing care group（n = 128） was given basic nursing care, and the evidence-based nursing group （n = 134） was given evidence-based nursing in- tervention according to the causes of accidental extubation. The incidence rate of accidental extubation, the incidence rate of accidental extubation at high risk periods at night and the satisfaction of nursing were compared between the two groups. Results The incidence rate of accidental extubation was 1.49%（2/134） in evidence-based nursing group, and the incidence rate of high-risk periods at night was 0.75%（1/134）. The incidence rate of accidental extubation in the routine nursing group was 11.72%（15/128）, and the incidence rate of high-risk periods at night was 6.25%（8/128）. The differences were statistically significant（P〈0.05）. The satisfaction rate in the evidence-based nursing group was 93.28% （125/134）, and the rate in the routine nursing group was 79.69%（102/128）. The difference was statistically significant （P〈0.05）. Conclusion Evidence-based nursing concept service model applied to ICU critically ill patient care helps to control accidental extubation risk events and to improve the patients＇ nursing satisfaction, which is worthy of popular- ization and application.