护理和出院障碍的复杂性:"现代内科患者". 来自CO-CARED研究的结果
Elisa Ceriani1, Olivia Milani2, Mattia Donadoni3
1Internal Medicine Department, Ospedale Luigi Sacco, ASST Fatebenefratelli-Sacco, Milan, Italy. elisa.ceriani@asst-fbf-sacco.it.
内科患者因临床不稳定性和社会脆弱性而面临越来越多的护理复杂性. 很大一部分需要专门的护理,突出需要更好的资源配置和支持系统.
科学领域:
- 老年病的医生 老年病的医生
- 内部医学 内部医学
- 医疗保健管理的管理
背景情况:
- 人口和社会变化正在增加内部医学中的患者复杂性.
- 有效的患者表征对于量身定制的干预至关重要.
研究的目的:
- 评估住院内科病人护理的复杂性.
- 评估临床不稳定性 (NEWS评分) 和护理依赖性 (mICD).
- 识别社会脆弱性及其对排放规划的影响.
主要方法:
- 这是一项前性多中心研究,涉及3912名患者.
- 综合护理复杂度 (ICC) 评分的计算.
- 国家早期预警分数 (NEWS) 和修改的机构护理依赖度 (mICD) 尺度的评估.
- 评估社会脆弱性和查尔森并发症指数 (CCI).
主要成果:
- 14.7%的患者有高的ICC分数,15%的患者有中度至重度的NEWS.
- 四分之一的患者表现出中度至严重的社会脆弱.
- 逗留时间与社会脆弱性,mICD和ICC相关,但不是NEWS.
- 住院死亡率与所有评估得分相关.
结论:
- 很大一部分内科病人的护理复杂性很高.
- 大约有15%的床位可以分配给临床不稳定的中期护理患者.
- 解决社会脆弱性对于患者护理和医院资源管理至关重要.
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