Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted...Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups,which were the control group(under general management)and the observation group(under the operating room nursing care management).Further,the incidence rate of nosocomial infections,the incidence rate of irregular nursing care phenomena,the satisfaction score of nursing care management,and the quality of life score were observed and recorded.Result:The incidence rate of nosocomial infection,the incidence rate of irregular nursing care management,the satisfaction score of nursing care management,and the quality of life score of the observation group were compared to that of the control group,and the result showed P<0.05,indicates the statistical significance between the data indicators.Conclusion:The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.展开更多
The present letter to the editor is related to the study entitled“Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors.”Not every microorganism grown in samples taken from crit...The present letter to the editor is related to the study entitled“Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors.”Not every microorganism grown in samples taken from critically ill patients can be considered as an infectious agent.Accurate and adequate information about nosocomial infections is essential in introducing effective prevention programs in hospitals.Therefore,the development and implementation of care bundles for frequently used medical devices and invasive treatment devices(e.g.,intravenous catheters and invasive ventilation),adequate staffing not only for physicians,nurses,and other medical staff but also for housekeeping staff,and infection surveillance and motivational feedback are key points of infection prevention in the intensive care unit.展开更多
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the in...Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the incidence and mortality of sepsis are high.^[1]As hospital infection control plays an essential role in treating the nosocomial infections in the ICU,and according to the clinical presentation of critically ill patients,the biological characteristics of pathogenic microorganisms and the ICU environment,this article put forward a strategy for the nosocomial infections in the ICU.展开更多
AIM:To describe and analyse factors associated with Clostridium difficile infection(CDI)severity in hospitalised medical intensive care unit patients.METHODS:We performed a retrospective cohort study of 40 patients wi...AIM:To describe and analyse factors associated with Clostridium difficile infection(CDI)severity in hospitalised medical intensive care unit patients.METHODS:We performed a retrospective cohort study of 40 patients with CDI in a medical intensive care unit(MICU)at a French university hospital.We include patients hospitalised between January 1,2007and December 31,2011.Data on demographics characteristics,past medical history,CDI description was collected.Exposure to risk factors associated with CDI within 8 wk before CDI was recorded,including previous hospitalisation,nursing home residency,antibiotics,antisecretory drugs,and surgical procedures.RESULTS:All included cases had their first episode of CDI.The mean incidence rate was 12.94 cases/1000admitted patients,and 14.93,8.52,13.24,19.70,and8.31 respectively per 1000 admitted patients annually from 2007 to 2011.Median age was 62.9[interquartile range(IQR)55.4-72.40]years,and 13(32.5%)were women.Median length of MICU stay was 14.0d(IQR 5.0-22.8).In addition to diarrhoea,the clinical symptoms of CDI were fever(>38℃)in 23 patients,abdominal pain in 15 patients,and ileus in 1 patient.The duration of diarrhoea was 13.0(8.0-19.5)d.In addition to diarrhoea,the clinical symptoms of CDI were fever(>38℃)in 23 patients,abdominal pain in 15 patients,and ileus in 1 patient.Prior to CDI,38patients(95.0%)were exposed to antibiotics,and 12(30%)received at least 4 antibiotics.Fluoroquinolones,3rdgeneration cephalosporins,coamoxiclav and tazocillin were prescribed most frequently(65%,55%,40%and 37.5%,respectively).The majority of cases were hospital-acquired(n=36,90%),with 5 cases(13.9%)being MICU-acquired.Fifteen patients had severe CDI.The crude mortality rate within 30 d after diagnosis was 40%(n=16),with 9 deaths(9 over 16;56.3%)related to CDI.Of our 40 patients,15(37.5%)had severe CDI.Multivariate logistic regression showed that male gender[odds ratio(OR):8.45;95%CI:1.06-67.16,P=0.044],rising serum C-reactive protein levels(OR=1.11;95%CI:1.02-1.21,P=0.021),and previous exposure to fluoroquinolones(OR=9.29;95%CI:1.16-74.284,P=0.036)were independently associated with severe CDI.CONCLUSION:We report predictors of severe CDI not dependent on time of assessment.Such factors could help in the development of a quantitative score in ICU’s patients.展开更多
<strong>Background: </strong>At present, there is no domestic research on the relationship between nurse staffing and hospital infection in very low birth weight infants. In this paper, we will explore the...<strong>Background: </strong>At present, there is no domestic research on the relationship between nurse staffing and hospital infection in very low birth weight infants. In this paper, we will explore the relationship between nurses of very low birth weight (VLBW) infants in neonatal intensive care unit (NICU) and nosocomial infections. <strong>Methods: </strong>The clinical data of 280 very low birth weight infants born in our hospital from January 2010 to January 2020 were collected, and the chi-square test and multiple logistic regression analysis were used to study the nursing staff of each very low birth weight infant who was admitted to the NICU The relationship between the number of infections and hospital infections. <strong>Results: </strong>On average, each nurse needs to care for 4.3 very low birth weight infants (lowest to highest: 2.50 - 8.42). In the univariate analysis, the higher the incidence of urinary tract infection (P < 0.05), the multivariate logistic regression analysis of neonatal nosocomial infection showed that nurse staffing was significantly related to the incidence of urinary tract infection (OR = 1.78;95% confidence interval, 1.17 - 2.35, P < 0.05). However, there was no significant correlation between nurse staffing and bloodstream infection (OR = 0.91;95% confidence interval, 0.74 - 1.06, P > 0.05) or Ventilator associated pneumonia (VAP) infection (OR = 1.17;95% confidence interval, 0.94 - 1.47, P > 0.05). <strong>Conclusion:</strong> Our research shows that in the neonatal intensive care unit, the reasonable deployment of nursing staff is an important factor in preventing urinary tract infections in very low birth weight infants. It is important for improving the survival rate of very low birth weight infants and reducing the occurrence of sequelae.展开更多
Objective:To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey.Methods:COVID-19 patients followed in the pandemic services ...Objective:To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey.Methods:COVID-19 patients followed in the pandemic services across Turkey between January 1,2021,and March 31,2022 were investigated retrospectively.Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19≥5 days after hospital admission.The primary outcome of this study was in-hospital mortality;demographic features and vaccination status was compared between survivors and non-survivors.Results:During the study period,15573 COVID-19 patients were followed in 18 centers and 543(3.5%)patients were nosocomial COVID-19.Most patients with nosocomial COVID-19(80.4%)were transferred from medical wards.162(29.8%)of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138(25.4%)of the patients died during hospital stay.Advanced age(≥65 years)and number of comorbid diseases(≥2)was found to be associated with mortality in nosocomial COVID-19(OR 1.74,95%CI 1.11-2.74 and OR 1.60,95%CI 1.02-2.56,respectively).Vaccination was associated with survival in nosocomial COVID-19(OR 0.25,95%CI 0.16-0.38).Conclusions:Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate.Vaccination can decrease the in-hospital mortality rate.展开更多
Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, ...Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1<sup>st</sup> January 2017 and 31<sup>st</sup> December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differences in quality of care provided by Level 1 and Level 2 ICUs in Poland, although more rigorous adhesion to admission and discharge policies is needed. Implementation of the instruments for assessing quality of ICUs including benchmarking, self-assessment of departments and evaluation of changes resulting from audits according to the Deming cycle is of utmost importance. Standardization of quality measures and markers, communication, and cooperation in reporting and creation of ICU medical registers is necessary to improve the quality of healthcare.展开更多
目的系统评价和整合重症监护病房(ICU)护士临床警报管理的认知、体验及期望,为提高警报管理水平,促进警报管理安全提供依据。方法检索PubMed、CINAHL、Web of Science、Embase、The Cochrane Library、乔安娜布里格斯研究所(JBI)循证卫...目的系统评价和整合重症监护病房(ICU)护士临床警报管理的认知、体验及期望,为提高警报管理水平,促进警报管理安全提供依据。方法检索PubMed、CINAHL、Web of Science、Embase、The Cochrane Library、乔安娜布里格斯研究所(JBI)循证卫生保健中心数据、EBSCO、PsyclNFO、中国知网、中国生物医学文献数据库、万方数据库、维普数据库,收集从建库至2023年3月1日关于ICU护士临床警报管理相关质性研究。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准(2020版)对文献质量进行评价,采用汇集性整合方法整合结果。结果共纳入13篇文献,提炼出48个原始研究结果,综合为9个新的类别,整合得出4个整合结果,包括ICU护士对警报管理的认知;警报管理负性体验;警报管理影响因素;期望及建议。结论应对护理人员进行全阶段的教育或调适,循证建立警报管理流程,配合多学科合作并优化技术支持,促进患者安全。展开更多
目的 探讨三级谵妄护理管理流程在神经内科重症监护室(neurology intensive care unit,NICU)急性脑卒中患者中的应用效果。方法 选择2021年5月至9月本院NICU收治的50例急性脑卒中患者作为研究对象并设为对照组,采取NICU预防谵妄的常规...目的 探讨三级谵妄护理管理流程在神经内科重症监护室(neurology intensive care unit,NICU)急性脑卒中患者中的应用效果。方法 选择2021年5月至9月本院NICU收治的50例急性脑卒中患者作为研究对象并设为对照组,采取NICU预防谵妄的常规护理措施;选择2021年12月至2022年4月收治NICU的50例急性脑卒中患者作为研究对象并设为试验组,试验组患者在对照组基础上实施三级谵妄护理管理流程,比较两组患者ICU谵妄(delirium in the intensive care unit,DICU)发生率、DICU持续时间、NICU住院时间、谵妄相关不良事件发生率;比较干预前后两组患者的谵妄水平和认知功能改善情况。结果 试验组患者DICU发生率较对照组低,两组比较,差异具有统计学意义(P<0.05)。试验组患者DICU持续时间、NICU住院时间较对照组短,谵妄相关不良事件发生率较对照组低;干预后试验组患者重症监护谵妄筛查量表(intensive care delirium screening checklist,ICDSC)评分低于对照组;试验组患者认知功能评分干预前后差值高于对照组,两组比较,差异有统计学意义(均P<0.05)。结论 在NICU急性脑卒中患者中实施三级谵妄护理管理流程可减少患者谵妄的发生,改善患者认知功能,缩短NICU住院时间,降低护理安全风险。展开更多
目的探讨基于循证证据的标准化管理对重症加强护理病房(intensive care units,ICU)心电监护患者误警报率及护士警报疲劳的影响。方法随机选取2021年7月—2023年6月月福建医科大学附属泉州市第一医院中临床100台ICU心电监护仪器。2021年...目的探讨基于循证证据的标准化管理对重症加强护理病房(intensive care units,ICU)心电监护患者误警报率及护士警报疲劳的影响。方法随机选取2021年7月—2023年6月月福建医科大学附属泉州市第一医院中临床100台ICU心电监护仪器。2021年7月—2022年12月实施常规管理期间的临床50台ICU心电监护仪器纳为常规管理组,将2023年1—6月实施基于循证证据的标准化管理期间的临床50台ICU心电监护仪器纳为循证管理组。比较2组心电监护患者误警报率、报警能力处理评分和护士警报疲劳。结果循证管理组的心电监护仪器误警报率为16.13%,常规管理组为26.15%,差异有统计学意义(P<0.05)。循证管理组中护士报警能力处理评分较常规管理组高,差异有统计学意义(P<0.05)。循证管理组患者的ICU护士报警疲劳量表评分为(15.32±3.28)分,常规管理组为(21.56±4.64)分,差异有统计学意义(P<0.05)。结论基于循证证据的标准化管理可以降低ICU心电监护患者误警报率,提升护士处理能力,降低护士报警疲劳度。展开更多
文摘Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups,which were the control group(under general management)and the observation group(under the operating room nursing care management).Further,the incidence rate of nosocomial infections,the incidence rate of irregular nursing care phenomena,the satisfaction score of nursing care management,and the quality of life score were observed and recorded.Result:The incidence rate of nosocomial infection,the incidence rate of irregular nursing care management,the satisfaction score of nursing care management,and the quality of life score of the observation group were compared to that of the control group,and the result showed P<0.05,indicates the statistical significance between the data indicators.Conclusion:The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.
文摘The present letter to the editor is related to the study entitled“Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors.”Not every microorganism grown in samples taken from critically ill patients can be considered as an infectious agent.Accurate and adequate information about nosocomial infections is essential in introducing effective prevention programs in hospitals.Therefore,the development and implementation of care bundles for frequently used medical devices and invasive treatment devices(e.g.,intravenous catheters and invasive ventilation),adequate staffing not only for physicians,nurses,and other medical staff but also for housekeeping staff,and infection surveillance and motivational feedback are key points of infection prevention in the intensive care unit.
文摘Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the incidence and mortality of sepsis are high.^[1]As hospital infection control plays an essential role in treating the nosocomial infections in the ICU,and according to the clinical presentation of critically ill patients,the biological characteristics of pathogenic microorganisms and the ICU environment,this article put forward a strategy for the nosocomial infections in the ICU.
基金Supported by A grant for her PhD from Sanofi Pasteur,France,to Khanafer N
文摘AIM:To describe and analyse factors associated with Clostridium difficile infection(CDI)severity in hospitalised medical intensive care unit patients.METHODS:We performed a retrospective cohort study of 40 patients with CDI in a medical intensive care unit(MICU)at a French university hospital.We include patients hospitalised between January 1,2007and December 31,2011.Data on demographics characteristics,past medical history,CDI description was collected.Exposure to risk factors associated with CDI within 8 wk before CDI was recorded,including previous hospitalisation,nursing home residency,antibiotics,antisecretory drugs,and surgical procedures.RESULTS:All included cases had their first episode of CDI.The mean incidence rate was 12.94 cases/1000admitted patients,and 14.93,8.52,13.24,19.70,and8.31 respectively per 1000 admitted patients annually from 2007 to 2011.Median age was 62.9[interquartile range(IQR)55.4-72.40]years,and 13(32.5%)were women.Median length of MICU stay was 14.0d(IQR 5.0-22.8).In addition to diarrhoea,the clinical symptoms of CDI were fever(>38℃)in 23 patients,abdominal pain in 15 patients,and ileus in 1 patient.The duration of diarrhoea was 13.0(8.0-19.5)d.In addition to diarrhoea,the clinical symptoms of CDI were fever(>38℃)in 23 patients,abdominal pain in 15 patients,and ileus in 1 patient.Prior to CDI,38patients(95.0%)were exposed to antibiotics,and 12(30%)received at least 4 antibiotics.Fluoroquinolones,3rdgeneration cephalosporins,coamoxiclav and tazocillin were prescribed most frequently(65%,55%,40%and 37.5%,respectively).The majority of cases were hospital-acquired(n=36,90%),with 5 cases(13.9%)being MICU-acquired.Fifteen patients had severe CDI.The crude mortality rate within 30 d after diagnosis was 40%(n=16),with 9 deaths(9 over 16;56.3%)related to CDI.Of our 40 patients,15(37.5%)had severe CDI.Multivariate logistic regression showed that male gender[odds ratio(OR):8.45;95%CI:1.06-67.16,P=0.044],rising serum C-reactive protein levels(OR=1.11;95%CI:1.02-1.21,P=0.021),and previous exposure to fluoroquinolones(OR=9.29;95%CI:1.16-74.284,P=0.036)were independently associated with severe CDI.CONCLUSION:We report predictors of severe CDI not dependent on time of assessment.Such factors could help in the development of a quantitative score in ICU’s patients.
文摘<strong>Background: </strong>At present, there is no domestic research on the relationship between nurse staffing and hospital infection in very low birth weight infants. In this paper, we will explore the relationship between nurses of very low birth weight (VLBW) infants in neonatal intensive care unit (NICU) and nosocomial infections. <strong>Methods: </strong>The clinical data of 280 very low birth weight infants born in our hospital from January 2010 to January 2020 were collected, and the chi-square test and multiple logistic regression analysis were used to study the nursing staff of each very low birth weight infant who was admitted to the NICU The relationship between the number of infections and hospital infections. <strong>Results: </strong>On average, each nurse needs to care for 4.3 very low birth weight infants (lowest to highest: 2.50 - 8.42). In the univariate analysis, the higher the incidence of urinary tract infection (P < 0.05), the multivariate logistic regression analysis of neonatal nosocomial infection showed that nurse staffing was significantly related to the incidence of urinary tract infection (OR = 1.78;95% confidence interval, 1.17 - 2.35, P < 0.05). However, there was no significant correlation between nurse staffing and bloodstream infection (OR = 0.91;95% confidence interval, 0.74 - 1.06, P > 0.05) or Ventilator associated pneumonia (VAP) infection (OR = 1.17;95% confidence interval, 0.94 - 1.47, P > 0.05). <strong>Conclusion:</strong> Our research shows that in the neonatal intensive care unit, the reasonable deployment of nursing staff is an important factor in preventing urinary tract infections in very low birth weight infants. It is important for improving the survival rate of very low birth weight infants and reducing the occurrence of sequelae.
文摘Objective:To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey.Methods:COVID-19 patients followed in the pandemic services across Turkey between January 1,2021,and March 31,2022 were investigated retrospectively.Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19≥5 days after hospital admission.The primary outcome of this study was in-hospital mortality;demographic features and vaccination status was compared between survivors and non-survivors.Results:During the study period,15573 COVID-19 patients were followed in 18 centers and 543(3.5%)patients were nosocomial COVID-19.Most patients with nosocomial COVID-19(80.4%)were transferred from medical wards.162(29.8%)of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138(25.4%)of the patients died during hospital stay.Advanced age(≥65 years)and number of comorbid diseases(≥2)was found to be associated with mortality in nosocomial COVID-19(OR 1.74,95%CI 1.11-2.74 and OR 1.60,95%CI 1.02-2.56,respectively).Vaccination was associated with survival in nosocomial COVID-19(OR 0.25,95%CI 0.16-0.38).Conclusions:Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate.Vaccination can decrease the in-hospital mortality rate.
文摘Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1<sup>st</sup> January 2017 and 31<sup>st</sup> December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differences in quality of care provided by Level 1 and Level 2 ICUs in Poland, although more rigorous adhesion to admission and discharge policies is needed. Implementation of the instruments for assessing quality of ICUs including benchmarking, self-assessment of departments and evaluation of changes resulting from audits according to the Deming cycle is of utmost importance. Standardization of quality measures and markers, communication, and cooperation in reporting and creation of ICU medical registers is necessary to improve the quality of healthcare.
文摘目的系统评价和整合重症监护病房(ICU)护士临床警报管理的认知、体验及期望,为提高警报管理水平,促进警报管理安全提供依据。方法检索PubMed、CINAHL、Web of Science、Embase、The Cochrane Library、乔安娜布里格斯研究所(JBI)循证卫生保健中心数据、EBSCO、PsyclNFO、中国知网、中国生物医学文献数据库、万方数据库、维普数据库,收集从建库至2023年3月1日关于ICU护士临床警报管理相关质性研究。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准(2020版)对文献质量进行评价,采用汇集性整合方法整合结果。结果共纳入13篇文献,提炼出48个原始研究结果,综合为9个新的类别,整合得出4个整合结果,包括ICU护士对警报管理的认知;警报管理负性体验;警报管理影响因素;期望及建议。结论应对护理人员进行全阶段的教育或调适,循证建立警报管理流程,配合多学科合作并优化技术支持,促进患者安全。
文摘目的 探讨三级谵妄护理管理流程在神经内科重症监护室(neurology intensive care unit,NICU)急性脑卒中患者中的应用效果。方法 选择2021年5月至9月本院NICU收治的50例急性脑卒中患者作为研究对象并设为对照组,采取NICU预防谵妄的常规护理措施;选择2021年12月至2022年4月收治NICU的50例急性脑卒中患者作为研究对象并设为试验组,试验组患者在对照组基础上实施三级谵妄护理管理流程,比较两组患者ICU谵妄(delirium in the intensive care unit,DICU)发生率、DICU持续时间、NICU住院时间、谵妄相关不良事件发生率;比较干预前后两组患者的谵妄水平和认知功能改善情况。结果 试验组患者DICU发生率较对照组低,两组比较,差异具有统计学意义(P<0.05)。试验组患者DICU持续时间、NICU住院时间较对照组短,谵妄相关不良事件发生率较对照组低;干预后试验组患者重症监护谵妄筛查量表(intensive care delirium screening checklist,ICDSC)评分低于对照组;试验组患者认知功能评分干预前后差值高于对照组,两组比较,差异有统计学意义(均P<0.05)。结论 在NICU急性脑卒中患者中实施三级谵妄护理管理流程可减少患者谵妄的发生,改善患者认知功能,缩短NICU住院时间,降低护理安全风险。
文摘目的探讨基于循证证据的标准化管理对重症加强护理病房(intensive care units,ICU)心电监护患者误警报率及护士警报疲劳的影响。方法随机选取2021年7月—2023年6月月福建医科大学附属泉州市第一医院中临床100台ICU心电监护仪器。2021年7月—2022年12月实施常规管理期间的临床50台ICU心电监护仪器纳为常规管理组,将2023年1—6月实施基于循证证据的标准化管理期间的临床50台ICU心电监护仪器纳为循证管理组。比较2组心电监护患者误警报率、报警能力处理评分和护士警报疲劳。结果循证管理组的心电监护仪器误警报率为16.13%,常规管理组为26.15%,差异有统计学意义(P<0.05)。循证管理组中护士报警能力处理评分较常规管理组高,差异有统计学意义(P<0.05)。循证管理组患者的ICU护士报警疲劳量表评分为(15.32±3.28)分,常规管理组为(21.56±4.64)分,差异有统计学意义(P<0.05)。结论基于循证证据的标准化管理可以降低ICU心电监护患者误警报率,提升护士处理能力,降低护士报警疲劳度。