护士连续性与重症监护病房死亡率之间的关联
Kathryn A Connell1, Billie S Davis2, Jeremy M Kahn3
1University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States.
Annals of the American Thoracic Society
|February 18, 2025
概括
在重症监护室 (ICU) 的护士连续性并没有降低患者死亡率,并且在某些情况下可能会增加患者死亡率. 需要进一步的研究来理解在重症监护机构中这种复杂的关系.
科学领域:
- 关键护理医学 关键护理医学
- 护理科学 护理科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 护理护理的连续性是重症监护室 (ICU) 实践中一个有价值的方面.
- 然而,护士连续性的直接影响患者的结果,特别是死亡率,仍然不完全理解.
研究的目的:
- 为了检查护士连续性和住院死亡率之间的关系,在重症监护病房的病人.
- 调查是否更高的护士连续性与患者生存率的改善或恶化有关.
主要方法:
- 一项回顾性队列研究利用了18家医院 (2018-2020年) 38个重症监护室的电子健康记录.
- 累积的护士连续性被测量为一个病人从返回的护士那里获得护理的班次比例.
- 使用后勤回归和比例危险回归分析了与住院死亡率的关系,并对混因素进行了调整.
主要成果:
- 这项研究分析了47564名ICU患者,其住院死亡率为10.4%.
- 累计的护士连续性随着时间的推移而增加,但更高的连续性显示出适度,统计学上显著的关联与某些班次死亡率的增加.
- 这些发现在各种敏感性分析中是一致的,包括子组分析和不同的统计建模方法.
结论:
- 在ICU的护士连续性没有发现与患者死亡率的降低有关.
- 有证据表明,护士连续性可能与特定重症监护机构的死亡率增加有关.
- 需要进一步调查以阐明导致护士连续性和ICU患者结果之间观察到的关联的潜在机制.
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