摘要
目的:了解重庆市地方医院综合性ICU的管理模式、人力资源及设备配置等现状及存在问题。方法:对我市二级及二级以上地方医院(不含军队医院及专科医院)的重症医学科(即综合性ICU或执行综合性ICU功能的专科ICU)采用网络问卷调查。结果:本次调查为普查,共76家医院,其中二级医院55家,三级医院21家。(1)53家综合性ICU采用封闭式管理,21家采用半封闭式,2家为开放式管理。(2)全市综合性ICU总床位与全市医院床位总数比为1.74%,ICU医生总数与ICU床位总数比为0.6∶1,ICU护士总数与ICU床位总数比为1.7∶1,三级医院综合ICU床位比例为(1.56±0.48)%,较二级医院(2.09±0.81)%低,但医护人员配置与床位数比例[医生:(0.75±0.36)∶1,护士:(1.83±0.78)∶1]较二级医院[医生:(0.55±0.35):1,护士:(1.50±0.60)∶1]高(P<0.05)。(3)综合性ICU男性医生比例较女性医生高,在二级医院(218∶138)及三级医院(127∶93)中没有明显差别(P>0.05),二级医院医生中职称及学历以初级及本科为主,而三甲医院中高级职称及中级职称比例明显增高,其中硕士研究生及博士研究生比例亦较二级医院高。(4)各级医院综合性ICU均有较为齐全的基础设备及仪器,能够开展大部分常规技术操作。(5)各级医院综合性ICU在院感防控、入室急性生理学及慢性健康状况(acute physiology and chroni health evaluation,APACHEⅡ)评分等质控方面较为重视,部分有专人负责,并能遵从相关指南要求。结论:重庆市重症医学较前明显进步,但仍存在人员配置不足、结构欠合理、部分常规技术开展不理想及新技术掌握不够等问题,且地区间发展不平衡。
Objective：To investigate the current status about administration,human and equipment resources and existing problems of Chongqing comprehensive intensive care units（ICUs）. Methods：All comprehensive ICUs or special ICUs which perform the function of comprehensive ICUs from secondary or tertiary hospitals in Chongqing（excluding military hospitals and specialized hospitals） were recruited for the web-based questionnaire survey. Results：This investigation is a general investigation,76 hospitals including 55 sec-ondary hospitals and 21 tertiary hospitals were included in the investigation. ①Fifty-one comprehensive ICUs were in closed management model,21 in semi-closed management model,2 in open management model respectively. ②The quantity of Reds in all comprehensive ICUs accounted for 1.74% of beds in all hospitals. The ratio of the amount of ICU doctors to the amount of total hospital beds was 0.6：1, and the ratio of nurses to beds was 1.7：1. The quantity of ICU beds accounted for （1.56 ± 0.48）% of all beds in tertiary hospitals, fewer than it in the secondary hospital （2.09 ± 0.81 ）% ,while the ratio of the quantity of ICU medical staffs to ICU beds were higher in tertiary hospitals than in the secondary hospital [doctor： （0.75 ± 0.36）：1, nurse： （ 1.83 ±0.78）：1 vs. doctor： （0.55 ± 0.35 ）：1, nurse： （ 1.50± 0.60）：1 ） （All P〈0.05 ）. ③There were more male doctors than female in comprehensive ICUs,but there was no significant difference between secondary and tertiary hospitals. Most of the doctors in secondary hospitals only got a very low level of primary title and college degree while there were more senior positions and intermediate titles in tertiary hospitals and the ratio of medicine master and doctor was higher in tertiary hospitals than in the secondary hospitals. ④All comprehensive ICUs had well-equipped instrument to conduct many normal opera- tions. ⑤The quality control like the prevention and control of hospital infection and A
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2017年第3期365-369,共5页
Journal of Chongqing Medical University
关键词
综合ICU
现状
调查
comprehensive intensive care units
current situation
investigation
