绵阳地区ICU危重患者康复活动情况调查分析

Investigation and Analysis of Rehabilitation Activities of Critically Ill Patients in ICU in Mianyang Area

目的调查绵阳地区所有医院ICU危重患者康复活动情况,探索适合本地区ICU环境的标准化早期康复方案。方法于2019年11月18~20日,采用整群抽样法对辖区ICU医务人员进行线上问卷星调查,采用自制问卷,分析一般资料、医院配置情况、ICU危重患者康复治疗情况及不同职称与职业医护人员对重症康复情况。结果共22家ICU 307名医护人员参与了此次调查,医生96名,护士204名,康复治疗师7名,职称以初级职称为主,医院等级以二甲为主。未每天配备康复治疗师的ICU占比81.82%,医生床位比平均0.42∶1,护士床位比平均1.69∶1,区域内ICU有可用的康复辅助工具的占比45.45%。仅22.73%的ICU常规每天开展危重患者康复活动,康复治疗主要由医师临床决策,康复师和护士主要参与,仅13.64%的ICU有康复治疗流程图及知情同意书。职称与康复治疗的临床益处了解程度呈正相关(P<0.05);不同职业对康复治疗的临床益处了解程度比较,差异有统计学意义(P<0.05)。职称与对康复治疗临床益处相信程度呈升高趋势(P<0.05),不同职业医护人员对康复治疗临床益处相信程度比较,差异无统计学意义(P>0.05)。职称与主动提出进行康复治疗频数呈正相关(P<0.05);不同职业医护人员主动提出康复治疗的频率比较,差异有统计学意义(P<0.05)。职称与医护人员对康复治疗过程的了解程度无相关性(P>0.05);不同职业医护人员对康复过程的了解程度间比较,差异有统计学意义(P<0.05)。职称等级与了解程度间呈正相关(P<0.05);不同职业对康复治疗可能的风险了解程度比较,差异有统计学意义(P<0.05)。结论ICU危重患者康复活动开展需加强配置,提高医务人员对危重症患者康复活动的认识,制定适合本地区ICU环境的标准化早期康复方案。

Objective To investigate the rehabilitation activities of critically ill patients in ICUs in all hospitals in Mianyang area,and to explore standardized early rehabilitation programs suitable for the ICU environment in the region.Methods From November 18 to 20,2019,a cluster sampling method was used to conduct an online questionnaire survey of ICU medical staff in the jurisdiction.A self-made questionnaire was used to analyze general information,hospital configuration,ICU rehabilitation and treatment of critically ill patients,and different professional titles.Occupational medical staff recover from severe illness.Results A total of 307 medical staff from 22 ICUs participated in the survey.There were 96 doctors,204 nurses,and 7 rehabilitation therapists.Their professional titles were junior titles,and the hospital's grades were mainly Grade A.The proportion of ICUs not equipped with rehabilitation therapists every day accounted for 81.82%,the average doctor bed ratio was 0.42:1,the average nurse bed ratio was 1.69:1,and 45.45%of the ICUs in the region had available rehabilitation aids.Only 22.73%of ICUs routinely carry out rehabilitation activities for critically ill patients every day.Rehabilitation treatment was mainly determined by the clinical decision-making of physicians,with the main participation of rehabilitation practitioners and nurses.Only 13.64%of ICUs had rehabilitation treatment flowcharts and informed consent.The professional title was positively correlated with the degree of understanding of the clinical benefits of rehabilitation treatment(P<0.05);the difference in the degree of understanding of the clinical benefits of rehabilitation treatment in different occupations was statistically significant(P<0.05).The professional title and the degree of belief in the clinical benefits of rehabilitation treatment showed an increasing trend(P<0.05).There was no statistically significant difference in the degree of belief among medical staff of different occupations in the clinical benefits of rehabilitation(P>0.05).The professional title was positively correlated with the frequency of active rehabilitation(P<0.05);the frequency of active medical staff in different occupations compared with the frequency of active rehabilitation,the difference was statistically significant(P<0.05).There was no correlation between the professional title and the medical staff's understanding of the rehabilitation process(P>0.05);the difference between the medical staff's understanding of the rehabilitation process of different occupations was statistically significant(P<0.05).There was a positive correlation between the level of professional title and the degree of understanding(P<0.05);the difference in the degree of understanding of possible risks of rehabilitation therapy in different occupations was statistically significant(P<0.05).Conclusion It was necessary to strengthen the deployment of rehabilitation activities for critically ill patients in ICU,improved medical staff's awareness of rehabilitation activities for critically ill patients,and formulated standardized early rehabilitation programs suitable for the ICU environment in the region.