摘要
目的探究儿童早期预警评分(PEWS)应用于儿童内科普通病房对患儿并发症发生率、非计划入住重症监护室比率、死亡/自动出院比率、住院天数及其家长和主管医生对护理人员满意度的影响。方法选取2017年6月—2019年12月期间入住电子科技大学医学院附属妇女儿童医院6个儿童内科普通病房的4896例患儿作为研究对象,按其住院号奇偶数分为对照组(2400例)和观察组(2496例)。对照组患儿护理中,护士根据医嘱,按照分级护理常规要求进行病情观察,若发现患儿病情变化,则根据经验判断上报护士或医生的时机及处理方式;观察组患儿护理中,护士采用PEWS对患儿进行评分,并根据预警评分值及相对应的处理原则决定上报上级护士或医生的时机及处理措施。比较两组患儿并发症(包括意识障碍、晕厥、急性呼吸功能障碍、急性心肌梗死、心绞痛、休克等)发生率、非计划入住重症监护室比率、死亡/自动出院比率、住院天数及患儿家长和主管医生对护理人员的满意度。结果观察组PEWS不同分值段患儿的非计划入住重症监护室比例差异有统计学意义(χ^(2)=4.865,P=0.001),观察组非计划入住重症监护室比例低于对照组(χ^(2)=6.529,P=0.011);两组患儿死亡/自动出院率比较差异无统计学意义(χ^(2)=0.035,P=0.906>0.05);并发症发生率低于对照组(χ^(2)=6.533,P=0.000);住院天数较对照组短(t=3.067,P=0.002);观察组医生满意度、患儿家长满意度均较对照组高(χ^(2)=4.954,P=0.000;χ^(2)=8.644,P=0.000)。结论儿童早期预警评分在儿童内科普通病房的应用,能够帮助护士快速识别并处理危重症患儿,进而降低其并发症的发生率,改善其预后,缩短其住院时间,提高家长及医生对护理工作的满意度。
Objective To explore the influence of pediatric early warning score(PEWS)on the incidence of complications,prognostic indicators,length of stay,and satisfaction of doctors and parents in pediatric internal medicine wards.Methods A total of 4896 pediatric patients admitted to 6 pediatric wards of our hospital from June 2017 to December 2019 were selected as research objects and were divided into two groups according to their admission number.In the control group,nurses observed the condition of 2400 children according to the doctor’s orders and the graded nursing routine requirements.If changes in the condition of children were found,the time and treatment method of reporting to the nurse or the doctor would be judged based on experience.In the observation group,nurses used PEWS to score the 2496 children,and decided the time and treatment measures to report to the superior nurse or doctor according to the early warning score and corresponding treatment principles.The incidence of complications(including disturbance of consciousness,syncope,acute respiratory dysfunction,acute myocardial infarction,angina,shock,etc.),the proportion of unplanned admission to intensive care unit,the proportion of death/automatic discharge,the length of stay,the satisfaction of parents and the incharge doctors to nurses were compared between the two groups.Results There was a significant difference in the rate of unplanned admission to intensive care unit in the observation group with different PEWS scores(χ^(2)=4.865,P=0.001),and the rate of unplanned admission to intensive care unit in the observation group was lower than that in the control group(χ^(2)=6.529,P=0.011).There was no significant difference in death/automatic discharge rate between the two groups(χ^(2)=0.035,P=0.906>0.05).The complication rate was lower than that of the control group(χ^(2)=6.533,P=0.000).The length of hospital stay was shorter than the control group(t=3.067,P=0.002).The satisfaction of doctors and parents in the observation group was higher than t
作者
王世平
王玉琼
王颖
WANG Shiping;WANG Yuqiong;WANG Ying(Women and Children's Hospital Affiliated to School of Medicine,University of Electronic Science and Technology of China,Chengdu Women and Children's Central Hospital,Chengdu 610091,China)
出处
《实用心脑肺血管病杂志》
2020年第S02期16-19,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
儿童早期预警评分
儿童
内科病房
并发症
非计划入住重症监护室
住院天数
满意度
Pediatric early warning score
Children
General medical wards
Complications
Unplanned admission to intensive care unit
Satisfaction
