摘要
目的探讨基于PRE-DELIRIC谵妄预测模型实施的风险分级预防护理措施在ICU患者中的运用效果。方法将288例重症患者按入院时间排序分为对照组141例(2017年5-10月)和干预组147例(2017年11月至2018年4月)。对照组实施常规护理措施,试验组入院时运用早期谵妄预测模型进行风险等级划分,并在此基础上根据谵妄风险等级实施谵妄预防的分级护理。采用一般资料收集表、疼痛数字评分法、重症监护疼痛观察量表、Richmond躁动与镇静量表、ICU意识模糊评估量表收集研究对象的基本资料和研究数据。比较2组患者的谵妄发生率、谵妄持续时间、28d生存率、ICU治疗时间进行统计学分析。结果干预组谵妄发生率21.70%(32/147),低于对照组的35.50%(50/141),差异有统计学意义(χ^2=5.043,P<0.05)。干预组患者谵妄持续时间(1.68±1.24)d,低于对照组的(2.82±1.60)d,差异有统计学意义(t=2.745,P<0.01)。干预组ICU住院日(3.42±3.02)d,低于对照组的(6.21±4.56)d,差异有统计学意义(t=4.45,P<0.01)。2组患者28dICU生存率比较差异无统计学意义(P>0.05)。结论结合PRE-DELIRIC谵妄预测模型实施的谵妄风险预防护理,能降低谵妄发生率,缩短谵妄持续时间和ICU住院日,改善患者预后。
Objective To study the application effect of graded nursing intervention for ICU patients combined with the Pre-Deliric prediction model.MethodsA total of 288 ICU patients were elected and divided into the control group(141 cases from May 2017 to October 2017)and the intervention group(147 cases from November 2017 to April 2018)according to hospitalization time.The control group received conventional delirium prevention measures.The intervention group was assessed within 24 h following admission with Pre-Deliric prediction model to screen the risk of delirium,and then they received grading prevention care based on the assessment results of delirium risks.The data of this study were collected by Numeric Rating Scale,Critical-Care Pain Observation Tool,Richmond Agitation and Sedation Scale,Confusion Assessment Method for the ICU.The incidence and duration of delirium,28d survival rate,ICU length of stay of the two groups were statistically analyzed.ResultsCompared with the control group,we detected that the incidence of delirium in the intervention group was significantly lower(χ^2=5.043,P<0.05),21.7%(32/147)vs.35.5%(50/141).Compared with the control group,we found that the duration of delirium in the intervention group was significantly shorter,(1.68±1.24)vs.(2.82±1.60)d,the ICU length of stay in the intervention group were significantly shorter than the control group(t=4.45,P<0.01),(3.42±3.02)d vs(6.21±4.56)d.There was no significant difference in the 28-day ICU survival rate between the two groups(P>0.05).Conclusionsthe risk assessment and grading nursing care combined with Pre-Deliric prediction model could effectively prevent the occurrence and shorten the duration of delirium,and also shorten the ICU length of stay.It was significant for improve the quality of nursing.
作者
邓露茜
曹岚
黄艳
田英
曾晓琳
肖帅
李健
Deng Luxi;Cao Lan;Huang Yan;Tian Ying;Zeng Xiaolin;Xiao Shuai;Li Jian(Department of Critical Care Medicine,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中国实用护理杂志》
2019年第9期704-708,共5页
Chinese Journal of Practical Nursing
