护士主导护理模式在危重症病人血糖管理中的应用研究

Applied research on nurse-led care model on blood glucose management in critically ill patients

[目的]观察护士主导护理模式在危重症病人血糖管理中的应用效果。[方法]选择2017年7月—2017年12月于某院综合性ICU住院的65例病人设为对照组,给予常规ICU护理,选择2018年7月—2018年12月于某院综合性ICU住院的65例病人设为观察组,给予护士主导护理模式,制定血糖控制标准化流程,包括血糖监测指证及频率、胰岛素起始静脉输注方案、持续胰岛素治疗时用量调整方法及低血糖处理等。比较两组病人血糖控制情况及每日胰岛素用量。[结果]干预后两组病人血糖水平均较干预前降低(P<0.001),两组间比较差异无统计学意义(P>0.05);观察组血糖达标时间、日胰岛素用量及低血糖发生率均低于对照组(P<0.05);与对照组相比,观察组平均血糖值(Ave)、血糖值标准差(SD)、血糖变异率(CV)均降低(P<0.05)。[结论]护士主导护理模式应用于危重病人的血糖管理不仅可以控制血糖,还可以缩短血糖达标时间、减少胰岛素用量,使血糖控制更安全。

Objective:To observe the applied effect of nurse-led care model on blood glucose management in critically ill patients.Methods:The 65 patients from July 2017 to December 2017 in ICU were selected as control group received normal ICU nursing,and the 65 patients from July 2018 to December 2018 were selected as observation group received nurse-led care model,to develop standardized blood glucose control procedures including the indication and frequency of blood glucose monitoring,the initial intravenous infusion of insulin,the dosage adjustment method of continuous insulin therapy and the treatment of hypoglycemia,etc.Blood glucose control and daily dose of insulin were compared between the two groups.Results:After intervention,the blood glucose level of patients in both groups was lower than that before intervention(P<0.001),but there was no significant difference between the two groups(P>0.05).In the observation group,the time of blood glucose reaching the standard,the daily dose of insulin and the incidence of hypoglycemia were all lower than those in the control group(P<0.05).Compared with the control group,the mean blood glucose value(Ave),blood glucose standard deviation(SD)and blood glucose variation rate(CV)in the observation group were all decreased(P<0.05).Conclusions:The nurse-led nursing mode applied to the blood glucose management of critically ill patients can not only stabilize the blood glucose control,but also shorten the time of blood glucose reaching the standard,reduce the amount of insulin,and make the blood glucose control safer.