在重症监护病房中,与护士相关的心脏病发作流行
J J Sacks1, D F Stroup, M L Will
1Division of Field Services, Centers for Disease Control, Atlanta, GA 30333.
JAMA
|February 5, 1988
概括
一个重症监护室 (ICU) 经历了一次与一名护士有关的心脏病发作. 这位护士照顾的患者的风险高出47.5倍,当她离开时,疫情停止了.
科学领域:
- 临界护理医学 临界护理医学
- 患者安全 患者安全
- 流行病学 流行病学
背景情况:
- 重症监护病房 (ICU) 是发生不良事件的高风险环境.
- 确定不良事件的模式和原因对于患者的安全至关重要.
- 在晚班期间观察到一组不寻常的心脏骤停.
研究的目的:
- 为了调查一场明显的流行性心脏骤停,发生在ICU的晚班期间.
- 确定这些不良事件的潜在风险因素和关联.
- 为了确定心脏骤停率增加的原因.
主要方法:
- 在1983年至1985年期间,对2219例ICU入院病人的回顾性审查.
- 在1984年1月至1985年3月期间,分析了88起晚班心脏骤停事件.
- 后勤回归分析以调整患者因素 (年龄,性别,疾病严重程度,术后状态).
- 专家对心脏骤停特征进行临床审查.
主要成果:
- 在疫情期间,一个特定的护士 (护士14) 负责 65% 的心脏骤停.
- 与其他护士的患者相比,14号护士的患者心脏骤停的风险高出47.5倍,即使调整了混因素.
- 在护士14的患者中,心脏骤停更有可能与无法解释的高血症和意想不到的时间一致.
- 随着14号护士离开ICU,心脏骤停的流行病停止了.
结论:
- 一个单一的医疗保健提供者与ICU中心脏骤停的流行病密切相关.
- 这些发现表明不良事件的潜在阳性原因.
- 建议实施强有力的流行病学监测系统,以检测医疗保健机构的不良结果.
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