创新型护理流程模式在重症监护病房机械通气患者中对护理质量的影响观察

Effect of innovative nursing process model on quality of care in patients with mechanical ventilation in intensive care unit

目的探讨创新型护理流程模式在重症监护病房机械通气患者中对护理质量的影响。方法选取2017年3月～2018年2月于我院ICU接受机械通气治疗的60例患者,随机数字表法分为对照组与研究组,每组各30例患者。对照组患者给予ICU常规护理流程模式,研究组患者给予创新型护理流程模式。自制护理质量评分表,观察并记录患者护理质量,评估患者并发症的发生情况。结果对照组患者机械通气用时为(8.33±1.07)d,研究组患者机械通气用时为(7.32±1.39)d;对照组患者住院时间为(7.19±0.55)d,研究组患者住院时间为(6.29±0.11)d。研究组患者的机械通气用时与住院时间显著短于对照组患者,两组比较差异有统计学意义(P <0.05),研究组患者各项护理质量指标评分均优于对照组患者,两组患者比较差异有统计学意义(P <0.05)。对照组中2例患者出现声门水肿,4例患者出现VAP,3例患者出现声带受损,研究组中1例患者出现VAP,1例患者出现声带受损,未见声门水肿患者。研究组患者并发症发生率为6.67%,显著低于对照组患者的30%,两组比较差异有统计学意义(P <0.05)。结论将创新型护理流程模式应用于重症监护病房机械通气患者的临床护理中,进行传统常规护理的流程再造与持续改进,能够显著提高ICU护理质量,降低机械通气患者并发症发生率,有效缩短机械通气用时与住院时间,值得临床大量推广应用。

Objective To explore the effect of innovative nursing process model on quality of care in patients with mechanical ventilation in intensive care unit.Methods Sixty patients who underwent mechanical ventilation in ICU of our hospital from March2017to February2018were selected,and divided into the control group and the research group by random number table method,each group had30patients.Patients in the control group were given ICU routine nursing process model,and the patients in the study was given innovative nursing process model.Self-made care quality score sheet was used to observe and record the quality of care,and assess the occurrence of complications.Results The mechanical ventilation time was(8.33±1.07)d of the control group,and(7.32±1.39)d of the study group.The hospitalization time was(7.19±0.55)d in the control group and(6.29±0.11)d in the study group.The mechanical ventilation time and hospitalization time of the study group were significantly shorter than the control group,the difference was statistically significant(P<0.05).The scores of nursing quality indicators in the study group were better than those in the control group,the difference was statistically significant(P<0.05).In the control group,2patients had glottic edema,4patients had VAP,3patients had vocal cord damage.In the study group,1patient had VAP,1patient had vocal cord damage,and no patients with glottic edema.The incidence of complications was6.67%in the study group,which was significantly lower than30%in the control group,the difference was statistically significant(P<0.05).Conclusion The application of innovative nursing process model in the clinical nursing of patients with mechanical ventilation in intensive care unit and the process reengineering and continuous improvement of traditional routine nursing can significantly improve the quality of ICU nursing,reduce the incidence of complications,effectively shorten the duration of mechanical ventilation and hospitalization,which is worthy of clinical promotion and application.