在护理转换期间记录儿科 Delirium:一个单站点的观察性研究
Matthew S Hazle1, Gabrielle Horner1,2, Melissa Ross1,2
1Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
Journal of intensive care medicine
|May 13, 2025
概括
儿科提供者经常未能记录从儿科重症监护室 (PICU) 转移到儿科医院医疗 (PHM) 服务的儿童妄症,尽管查结果呈阳性. 这种不足的文件可能会导致患者的治疗结果更差.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 儿童神经学 儿童神经学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 痴呆症是重症儿童的常见并发症,与不良结果有关.
- 儿童妄的有效管理需要在护理过渡期间准确的记录.
- 康奈尔儿科狂妄症评估 (CAPD) 是一个经过验证的儿童狂妄症查工具.
研究的目的:
- 为了确定在护理过渡期间的妄想记录率.
- 为了确定与儿科患者的妄想记录相关的因素.
- 评估从儿科重症监护室 (PICU) 转移到儿科医院医疗 (PHM) 服务和出院时的文件.
主要方法:
- 从2016年到2022年,对337名患者 (年龄在0-21岁) 进行了回顾性分析.
- 纳入标准:在PICU转移到PHM之前,通过CAPD选阳性 Delirium.
- 结果:记录PICU转移和出院时的"妄想";使用双变量和多变量逻辑回归进行统计分析.
主要成果:
- 狂妄症仅在20%的转移和18%的排放中被记录.
- 增加文档的因素包括精神病咨询和侵入性机械通风 (MV).
- 黑人种族与文档的几率下降有关;黑人种族 (OR 0.275),精神病咨询 (OR 66.82),以及传输时的侵入性MV (OR 6.495).
结论:
- 尽管使用了经过验证的查工具,但在护理过渡期间,儿科 Delirium 文档特别低.
- 不足够的文档可能会危及患者的安全,并导致更差的结果.
- 精神病咨询和侵入性MV是与 delirium 记录增加相关的关键因素.
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