ICU护士评估Richmond躁动-镇静量表准确性现状调查及影响因素分析

Status and influencing factors on accuracy of estimation in applying Richmond Agitation Sedation Scale by nurses of Intensive Care Unit

目的调查ICU护士应用Richmond躁动-镇静量表（RASS）评估ICU患者镇静状态的准确性现状，探讨影响其准确性的相关因素。方法采用便利抽样法，选取2016年11月-2017年1月北京市某三甲医院ICU患者206例和38名ICU护士。研究组与ICU护士分别采用RASS评估患者躁动-镇静状态，分析其差异及影响因素。结果与研究组相比，ICU护土评估RASS一致的患者143例，准确率为69．4％。Logistic多因素回归分析显示，镇静药物、Glasgow评分、谵妄为影响RASS评估正确性的影响因素（OR值分别为0．065、1．424、0．201；P〈0．05）。结论ICU护士应用RASS准确性处于中等水平；在ICU护士应用RASS过程中，对应用镇静药物的患者、谵妄患者以及Glasgow评分较低的患者应予以关注。

Objective To investigate the status on accuracy of estimation in applying Richmond Agitation-Sedation Scale （RASS） by nurses of Intensive Care Unit （ICU） for sedation of critically ill patients and to explore its influencing factors. Methods From November 2016 to January 2017, we selected 206 ICU patients and 38 ICU nurses of a Class m Grade A hospital in Beijing by convenience sampling. Research group and ICU nurses respectively assessed patients＇ agitation-sedation state with the RASS and analyzed its differences as well as influencing factors. Results There were 143 patients assessed by ICU nurses with the RASS in accordance with that in research group with 69.4% for the accuracy rate. Logistic regression analysis showed that the influencing factors of accuracy of estimation in RASS included sedative, score of Glasgow and delirium （OR=0.065, 1.424, 0.201 ; P〈0.05）. Conclusions The accuracy of estimation in applying RASS by ICU nurses is at a middle level. We should pay attention to patients with sedative, delirium and the low score of Glasgow during applying RASS for critically ill patients.