多元集成护理策略在重症肺炎机械通气患者睡眠改善与ICU获得性谵妄防控中的效果分析

Effectiveness Analysis of Multifaceted Integrated Care Strategy in Sleep Improvement and ICU Acquired Delirium Prevention and Control in Mechanically Ventilated Patients with Severe Pneumonia

目的:探讨多元集成护理策略在重症肺炎机械通气患者睡眠改善与ICU获得性谵妄防控中的应用效果,为临床护理提供依据。方法:选取2020年1—12月广东医科大学附属第二医院ICU收治的100例重症肺炎机械通气患者作为研究对象,采用摸球法分为试验组和对照组,每组各50例。对照组采用常规护理干预,试验组在常规护理基础上实施多元集成护理策略干预。比较两组患者ICU获得性谵妄发生率、谵妄发生时间及谵妄持续时间,睡眠质量评分。结果:试验组患者干预后ICU获得性谵妄发生率、发生时间与持续时间均显著低于对照组,差异有统计学意义(χ^(2)=5.828;t=4.162、-3.720,P<0.05)。干预前,两组患者睡眠质量评分比较,差异无统计学意义(t=-0.400,P>0.05);干预后,试验组患者睡眠质量评分显著低于对照组,差异有统计学意义(t=-10.932,P<0.05)。结论:采用多元集成护理策略对重症肺炎机械通气患者进行干预,能够取得积极的ICU谵妄防控效果,改善护理对象睡眠质量。

Objective:To explore the application effect of multifaceted integrated nursing strategies in sleep improvement and ICU acquired delirium prevention and control in mechanically ventilated patients with severe pneumonia,and to provide a basis for clinical care.Methods:100 cases of mechanically ventilated patients with severe pneumonia admitted to the ICU of the hospital from January to December 2020 were selected as the study subjects,and they were divided into the experimental group and the control group by using the touch-ball method,with 50 cases in each group.The control group used conventional nursing interventions,and the experimental group implemented multifaceted integrated nursing strategy interventions on the basis of conventional nursing.The incidence rate of ICU-acquired delirium,delirium onset time and delirium duration,and sleep quality score were compared between the two groups.Results:The incidence,time of occurrence and duration of ICU-acquired delirium in the experimental group were significantly lower than those in the control group after the intervention,and the difference was statistically significant(χ^(2)=5.828;t=4.162,-3.720,P<0.05).Before the intervention,there was no statistically significant difference in sleep quality scores between the two groups(t=-0.400,P>0.05).After the intervention,the sleep quality scores of the experimental group were significantly lower than those of the control group,and the difference was statistically significant(t=-10.932,P<0.05).Conclusion:The use of multifaceted integrated care strategies to intervene in mechanically ventilated patients with severe pneumonia in the ICU can achieve positive ICU delirium prevention and control results and improve sleep quality in care recipients.