对澳大利亚重症监护病人的息护理参与进行了为期四年的回顾性研究
Mark P Collins1, Patrick Steele2,3, Lewis Hackenberger4,5
1Department of Intensive Care, Peninsula Health, Frankston, Australia.
在重症监护室 (ICU) 发生的死亡中,专家息护理的参与率很低,但在ICU病房后发生的死亡中,这一比例很高. 目前的ICU转诊工具不足以识别需要息治疗的患者.
科学领域:
- 关键护理医学 关键护理医学
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 专家息治疗 (SPC) 整合到重症监护室 (ICU) 对于终身护理至关重要.
- 目前在ICU中治疗息治疗的转诊实践有很大的差异.
- 国际工具已经存在,以指导ICU中的息治疗转诊,但它们的有效性需要评估.
研究的目的:
- 描述SPC参与ICU和ICU后病房的情况.
- 为了比较当前的ICU息护理转诊实践与已建立的转诊工具.
- 评估转诊工具在确定患者需要息治疗方面的有效性.
主要方法:
- 澳大利亚墨尔本大学附属ICU的11,449名ICU入院患者 (10,171名患者) 的回顾性队列研究 (2019年7月 - 2023年7月).
- 分析SPC参与,患者结果 (ICU和ICU后死亡率) 和转诊模式.
- 观察到的转诊实践与国际ICU息护理转诊工具的比较.
主要成果:
- 整体ICU死亡率为9%,加上4.3%的ICU后死亡率.
- 在ICU死亡的患者中,SPC参与率很低 (7.5%),但在ICU后死亡的患者中,SPC参与率很高 (59%).
- 与实际实践相比,转诊工具的灵敏度较低 (39%);ICU工作人员提供了大多数ICU息治疗,而咨询服务占据了ICU后病房的主导地位.
结论:
- 目前的ICU息护理转诊实践与现有的工具不太符合.
- 在ICU退院后,息护理的提供从ICU工作人员转移到专业咨询服务.
- 评估的转诊工具不足以识别在ICU环境中需要息治疗的患者.
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