以服务清单为指导的过渡期护理在ICU转出心脏手术迁移应激家属中的应用研究

Application value of checklist-based transitional care on patients relatives relocation stress in patients undergoing cardiac surgery

目的探讨基于服务清单的过渡期护理在ICU转出心脏手术迁移应激家属中的应用价值。方法将2017年5月至2019年10月四川省乐山市人民医院行心脏外科手术的92例患者根据入院时间分为试验组和对照组,每组46例。对照组接受常规ICU过渡期护理,试验组在此基础上采用护理服务清单管理。比较2组转科交接时间、术后首次下床活动时间、住院时间和术后并发症发生率;采用ICU转出患者家属迁移应激量表评价患者家属迁移应激水平。结果试验组转科交接时间为(11.80±3.58)min、术后首次下床活动时间为(18.65±4.63)min、ICU后综合征发生率为4.35%(2/46),明显低于对照组的(13.83±3.49)min、(21.37±4.97)min、17.39%(8/46),差异有统计学意义(t值为2.739,2.713,χ^(2)值为3.866,P<0.05)。ICU转出后,试验组迁移准备、家属压力、迁移满意度得分和迁移应激总分分别为(21.11±2.57)、(13.83±2.10)、(7.57±1.11)、(50.54±3.44)分,明显高于对照组的(19.65±3.28)、(12.48±2.16)、(6.76±1.62)、(46.43±4.11)分,差异有统计学意义(t值为9.222~20.187,P<0.05)。结论基于服务清单的过渡期护理能够缩短心脏外科手术患者ICU转运时间和减少术后并发症,减轻患者家属的迁移应激水平。

Objective To explore the application value of checklist-based transitional care on patients relatives relocation stress in patients undergoing cardiac surgery.Methods A total of 92 patients who undergoing cardiac surgery were assigned to experimental group(n=46)and control group(n=46).Patients in the control group received routine ICU transitional care,the experiment group carried out checklist-based ICU transitional care.The transfer time,time of early ambulation,length of hospitalization and incidence of postoperative complications were compared between two groups.Meanwhile,the relatives stress levels were assessed by family relocation stress scale.Results The transfer time,time of early ambulation and post-intensive care syndrome rate were(11.80±3.58)min,(18.65±4.63)min and 4.35%(2/46)in the experimental group,significantly lower than those in the control group[(13.83±3.49)min,(21.37±4.97)min,17.39%(8/46)],the difference was statistically significant(t value was 2.739,2.713,χ^(2) value was 3.866,P<0.05).After ICU transferring,the scores of preparation for relocation,family burden,satisfaction with the relocation process and total relocation stress were 21.11±2.57,13.83±2.10,7.57±1.11 and 7.57±1.11,significantly higher than in the control group(19.65±3.28,19.65±3.28,6.76±1.62,46.43±4.11),the difference was statistically significant(t value was 9.222-20.187,P<0.05).Conclusions Checklist-based transitional care can reduce ICU transfer time,decrease postoperative pain and complications in patients undergoing cardiac surgery,which can also alleviate the levels of relatives relocation stress.