记录和评估即将死亡患者的护理
Maria de Freitas1, Lucinda Roberts1, Alexandra Cockroft1
1Eastern Health, Australia.
在COVID-19大流行期间,重症监护室的生命终端护理 (EOLC) 质量得到了改善,与大流行前的审计相比,DECODE得分更高. 这表明,尽管处于具有挑战性的环境中,但护理水平仍有所提高.
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:
- 在重症监护室 (ICU) 的生命终端护理 (EOLC) 提出了重大挑战,包括诊断不确定性和有限的时间框架.
- 评估EOLC的质量对于改善患者护理和结果至关重要.
- 死亡护理的记录和评估方程 (DECODE) 工具提供了一种半客观的衡量方法,用于评估ICU中的EOLC质量.
研究的目的:
- 在COVID-19大流行期间评估ICU中EOLC的文档和交付质量.
- 将疫情期间的EOLC质量与疫情前的审计进行比较.
主要方法:
- 在2021年1月至2022年2月期间,澳大利亚维多利亚州三个大都会成人重症监护室中死亡的患者的医疗记录的回顾性临床审计.
- 使用DECODE调查工具来评估EOLC的质量.
- 将调查结果与大流行前的审计数据进行比较.
主要成果:
- 在194例死亡中,43%的病人的愿望被记录在案. 91%的人在死亡前24小时接受了积极治疗.
- 预计将有86%的死亡. 只有27%的人有息或症状控制护理计划.
- 中位数的DECODE得分为14,显示了不同地点的统计差异 (p=0.001). DECODE的分数高于疫情前的审计 (p=0.001).
结论:
- 在ICU中的EOLC仍然很复杂,受到诊断和预后不确定性的影响.
- DECODE问卷提供了一种有价值的工具,用于评估和潜在地提高ICU中垂死患者的护理质量.
- 尽管存在大流行的限制,但通过DECODE得分来衡量EOLC的质量,与大流行前的水平相比,仍有所改善.
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