重症监护室探视制度的现状调查

Investigation and Research on the Current Situation of Intensive Care Unit Visiting Policy

目的通过了解现存重症监护室探视制度以及调查重症监护室医务人员对现存探视制度的观点和态度,从一线工作人员角度探寻现有重症监护室探视制度下的工作不足之处,分析其原因并提出相应建议,为探索新型重症监护室探视制度标准提供参考。方法采用自制的《重症监护室医务人员对家属探视制度的态度问卷》对便利抽样的江苏省62所医院的283名重症监护室医务人员进行现状调查。结果参研医院中,绝大多数(96.77%)的重症监护室接受家属探视,最常见的探视方式是直接进入监护室探视,探视时段多集中于下午,探视时长集中于30分钟内,且大多数的重症监护室限制探视人数在2人内,不允许儿童探视;ICU医务人员对探视制度的态度评分最高的三个条目分别为家属探视能减少患者和家属的担忧和焦虑(3.87±0.81);家属探视便于获取患者病史资料(3.48±0.86);家属探视增加医务人员的顾虑(3.47±0.78)。不同行政职务及技术职称的医务人员,对ICU探视制度的态度不同,其差异具有统计学意义(P<0.05)。阻碍ICU家属探视开展的原因中,排在前三位的分别为:院感控制或细菌扩散(3.92±0.91)、患者情况不稳定(3.61±0.92)、护士工作量大(3.47±1.01)。结论重症监护室医务人员对现存的探视制度持有怀疑态度,了解影响探视制度开展的因素并打破传统探视观念、改变传统探视模式探索新型的探视制度很有必要。

Objective By investigating the existing ICU visiting system and the opinions and attitudes of the ICU medical staff on the existing system,this paper explored the shortcomings of the existing ICU visiting system from the perspective of frontline staff,analyzed the causes and proposed corresponding suggestions,so as to provide a reference for exploring new standards for ICU visiting system.Methods A self-designed questionnaire"Attitudes of ICU Medical Staff Toward the Visiting Policy"was used to investigate the status of 283 ICU medical staff in 62 hospitals in Jiangsu Province.Results The vast majority of hospitals involved in the survey(96.77%)received family visits,with going to the nursing home directly as the most common way.The visiting hours were mostly in the afternoon,with the duration of visits lasting within 30 minutes.Most ICUs limit visits to two people and do not allow children to visit.The top three attitudes of ICU medical staff toward the visiting system were as follows:(1)Family visits can reduce the concern and anxiety of both patients and their families(3.87±0.81);(2)Family members had easier access to patients’history data(3.48±0.86);(3)Family visits increase the concerns of medical staff(3.47±0.78).Medical staff with different administrative positions and technical titles had different attitudes toward the ICU visiting system,and the difference was statistically significant(P<0.05).Among the reasons that hindered ICU family members from visiting,the top three were:sense of control or bacterial spread(3.92±0.91),unstable status of patients(3.61±0.92),and heavy workload on nurses(3.47±1.01).Conclusion The ICU medical staff are not satisfied with the existing visiting system.It is extremely urgent to understand the factors affecting the development of the visiting system and to break through the traditional visiting concept and alter the traditional visiting mode,so as to explore a new model of visiting system.