以分级护理为基础的ICU病人护理动态管理的影响

目的:探讨通过分级护理的方法,满足各级别病人的护理需求,并且提高护理人员的人力使用率,均衡其工作量,减少过重负荷。方法:选择2016年1月~4月我院收治ICU重症患者198例,以及护理人员28人,采用随机数字表法将其均分成实验组和对照组。对照组采用传统护理模式。实验组采用分级护理模式,包括床位分配、人力预估、自我核查、人力分配。研究过程中,统计压疮等并发症的发生情况,并且每10天对护理人员做满意度调查。结果:①分级护理方法能够将实验组中99例患者所需的护理工作量较有效的进行区分,并且与TISS-28呈正相关;②两组患者的压疮、导管相关性血行感染、呼吸机相关肺炎以及非计划性拔管等并发症的发生率差异均具有统计学意义(P<0.05),且实验组显著低于对照组;③实验组的护理人员对护理工作量、工作量分配均衡性、床位分配公平性、ICU全体患者护理需求满足程度、ICU护理人员使用有效程度及护理方法的满意度评分比对照组都有所提升,且差异均具有统计学意义(P<0.05)。结论:分级护理的管理方法不仅能更好的满足不同级别患者的护理需求,提高其自身的配合程度、自理能力,缓解疾病的发展,让ICU患者更好地进行康复,还能均衡护理人员的工作量,减少护士工作负荷,提高护理质量,充分利用人力物力,保证整个ICU护理人员工作的良好运作与协调,值得进一步研究与推广。

Objective:To explore the way of meeting the demand of patients at all levels of nursing,improving nursing manpower utilization rate,balancing the workload and reducing the heavy load by the method of grading nursing.Methods:From January 2016 to April 2016,198 patients in ICU and 28 nurses in our hospital were divided into 2 groups.Clinical data and self-management were collected and analyzed between two groups on average.Control group used traditional nursing mode,while experimental group used grading nursing(including bed distribution,human resource,manpower forecast and self check).In the research,the occurrence of complications such as pressure ulcers were collected,and did the satisfaction survey on nursing staff every 10 days.Results:①Grading nursing method on 99 patients in experimental group could distinguish nursing workload effectively,and it were positively correlated with TISS-28;②The incidence of complications such as pressure sores,catheter-related bloodstream infection,entilator-associated pneumonia and unscheduled tube drawing between two groups were statistically different(P<0.05),and experimental group was significantly lower than control group;④Comparing with control group,the satisfaction scores of nursing staff in experimental group for nursing workload allocation fairness and workload balance,beds,all ICU patients nursing demand satisfaction,all of ICU nursing staff to use effective degree and satisfaction of nursing method were improved,and the differences were statistically significant(P<0.05).Conclusion:Grading nursing management method can not only meet the needs of patients in different levels,improve their cooperation and self-care ability,relieve the progress of the disease,rehabilitate ICU patients,but can also balance nursing workload,reduce the nurse workload,improve the quality of nursing,make full use of resources,ensure good operation of the ICU nursing staff to work and coordination,which deserves further research and extension.