神经外科患者的息护理咨询模式
Sawyer Kieffer1, John Arce2, Amy Ogilvie3
1Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
The American journal of hospice & palliative care
|May 18, 2024
概括
在神经外科 (NSG) 患者的息护理 (PC) 整合改善了终身护理. 电脑咨询与ICU死亡人数减少以及对护理目标和预先护理规划的更好的记录有关.
科学领域:
- 神经外科 神经外科
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 神经外科 (NSG) 条件往往导致严重的发病率,死亡率和延长的重症监护室 (ICU) 停留.
- 息护理 (PC) 改善了患者和家庭的结果,使治疗与偏好保持一致,并降低了成本.
- 关于影响NSG患者接受PC的因素的研究有限.
研究的目的:
- 在住院的NSG患者中确定与PC咨询相关的人口和临床因素.
- 为了比较接受PC的NSG患者与接受通常NSG护理的患者的生命终结结果.
主要方法:
- 从2017年1月1日到2018年12月31日,对NSG患者的回顾性图表审查.
- 收集有关人口统计,临床结果和护理目标 (GOC) 和预先护理计划 (ACP) 文件的数据.
- 分析了121名已故患者的数据,比较了PC转诊患者和没有PC转诊患者的数据.
主要成果:
- 在121名死亡患者中,97名 (80.2%) 患有PC转诊.
- 结核病患者住院时间较长 (10.3 vs. 4天) 和更多的ICU护理 (90.7% vs. 83.3%).
- PC患者的ICU死亡人数减少了 (42.3%与75%相比),舒适度增加了 (PCA/NCA使用率为51.5%与8.3%相比),更多的DNR订单 (90.7%与62.5%相比),以及更好的GOC (78.4%与0%) 和ACP文件 (35.1%与16.7%).
结论:
- 神经外科手术中的息护理整合与改善的终身护理有关.
- 专家咨询促进了符合目标的护理,并加强了关于患者偏好的沟通.
- 进一步的研究应该探索PC集成到NSG的最佳模型.
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