质量指标监测在ICU患者约束集束化护理管理中的应用

Application of the Quality Index Monitoring on Physical Restraint Nursing Management among Patients in Intensive Care Units

目的探讨基于循证的集束化护理措施在ICU患者身体约束管理中的效果。方法采用目的抽样法,选取杭州市某医院ICU对患者进行身体约束集束化护理,对改进前后相关数据进行比较。结果身体约束率、约束医嘱正确开具率、约束告知率、约束评估符合率、护士身体约束知信行改进前后有明显统计学差异(P<0.01);身体约束率下降后,非计划拔管率无明显上升(P>0.05)。结论通过基于循证的身体约束集束化管理,可以提高ICU护士对患者身体约束实践行为认知,促进身体约束过程更规范,在降低ICU患者身体约束时不提高非计划拔管率,保证了护理质量和安全,又能改善患者体验,体现人文护理。

Objective To explore the effect of evidence-based clustering nursing measures in the management of physical restraint among patients in the Intensive Care Units(ICU).Methods The relevant data before and after physical restraint clustering nursing management were compared by using the purpose sampling method to select the ICU of a hospital in Hangzhou.Results There were significant statistical differences on the physical restraint rate,the correct prescription rate,the constraint notification rate,the constraint assessment compliance rate,and the nurse's physical restraint knowledge between the groups(P<0.01).After the physical restraint rate decreased,the unplanned extubation rate did not significantly increased(P>0.05).Conclusion Through evidence-based physical restraint management,nurses can improve their awareness of physical restraint practice behavior,promote the process of physical restraint,and improve the quality of care without increase the unplanned extubation rate when reducing the physical constraint of ICU patients.Furthermore,the nursing quality and safety were ensured,and the patient experience was improved with reflecting humanistic care.