在心脏重症监护病房中,先进实践提供者和家务人员团队之间的结果进行比较
Robert S Zhang1, Peter Zhang2, Eric Bailey2
1Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.
JACC. Advances
|November 21, 2024
概括
高级实践提供者 (APP) 和家庭工作人员团队在心脏重症监护室 (CICU) 的患者死亡率相似. 这项研究发现结果没有显著差异,支持在重症监护机构使用APP.
科学领域:
- 关键护理医学 关键护理医学
- 医疗保健管理的管理
背景情况:
- 越来越多的临床护理专业知识需求需要创新的人员配置模式.
- 高级实践提供者 (APP) 正在成为解决密集主义者的局限性的解决方案.
- 本研究评估了APP团队在心脏重症监护室 (CICU) 的表现.
研究的目的:
- 为了比较APP领导的和家庭工作人员领导的CICU团队之间的患者结果.
- 评估APP人员对死亡率和逗留时间的影响.
- 评估APP团队对心脏病学奖学金培训的影响.
主要方法:
- 从2022年3月到2023年7月,对比两个CICU团队 (家庭工作人员与APP) 的回顾性研究.
- 对1620名患者入院的分析,重点关注死亡率和入院时间.
- 多变量考克斯回归和卡普兰-梅尔分析用于初级结果评估.
主要成果:
- 在APP和家庭工作人员团队之间,在CICU死亡率 (8.4%与8.2%) 或住院死亡率 (13.5%与13.8%) 中没有显著差异.
- 观察到类似的患者人口统计,入院诊断和重症监护干预措施的使用.
- 在APP团队中,奖学金轮换得分有所提高 (3.87至4.61,P<0.0001).
结论:
- 由APP管理的团队和由家庭工作人员管理的团队在CICU中产生了可比的患者死亡率.
- 这些发现支持将APP整合到重症监护人员配置模型中.
- 使用APP可以提高心脏病学奖学金培训的质量.
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