成人危重症患者分级护理研究

Hierarchical Nursing of Adult Critically Ill Patients

目的探索成人危重症患者分级护理方案,以期为重症监护病房实施分级护理管理提供参考。方法于2019年5月-11月,以课题组前期研究为基础,采用危重症患者病情严重程度评估体系和护理工时评估体系共16个变量对300例ICU住院患者进行测评,应用聚类分析方法进行数据降维,确定护理分级。结果300例成人危重症患者聚类为三个护理亚群,并根据类属特征将其命名为特A级护理、特B级护理和特C级护理。特A级护理亚群患者病情最重,所需护理工时最长;特B级护理亚群呈现两种情况,一种为患者病情严重但所需护理工时较短,另一种为患者病情较轻但所需护理工时较长;特C级护理患者病情最轻,所需护理工时最短。结论基于聚类分析法确定的成人危重症患者分级护理方案科学性较好,初步获得分级护理基本特征,能够为危重症患者分级护理管理提供参考。

Objective To explore the hierarchical nursing plan for adult critically ill patients and to provide reference for the implementation of hierarchical nursing management in Intensive Care Unit(ICU).Methods From May to November,2019,based on the preliminary research,300 ICU inpatients were evaluated with 16 variables of the severity assessment system and nursing work hour evaluation system of critical ill patients,and cluster analysis method was used for data dimensionality reduction to determine the nursing grade.Results 300 adult critically ill patients were grouped into three nursing subgroups,which were named as special grade A nursing,special grade B nursing and special grade C nursing according to their category characteristics.Patients in the special grade A nursing subgroup were the sickest and needed the longest nursing hours.The special B nursing subgroup presented two conditions,one for patients with severe conditions but short nursing hours,and the other for patients with mild conditions but long nursing hours.The special C grade nursing patients were the least ill and required the shortest nursing hours.Conclusion The hierarchical nursing plan for adult critically ill patients based on cluster analysis method was scientific,and the basic characteristics of the hierarchical nursing were obtained preliminarily,which can provide reference for the hierarchical nursing management of critically ill patients.