摘要
目的探讨多学科床边查房信息化清单在ICU的临床应用效果。
方法选取浙江大学医学院附属邵逸夫医院的综合性ICU 2016年10月至2017年9月收治的1 172例患者为试验组，采用ICU多学科床边查房信息化清单进行结构化查房；选取2015年10月至2016年9月收治的886例采用常规床边查房的患者为对照组，比较2组机械通气时间和住ICU时间、院内感染发生率和导管使用率（中心静脉导管、人工气道和导尿管）以及ICU医务人员对多学科合作的满意度。
结果试验组机械通气时间和住ICU时间分别为1.42（0.68，3.63）、3.19（2.48，5.40）d，对照组分别为2.16（1.40，4.77）、4.14（3.46，6.92）d，2组比较差异有统计学意义（t=-9.745、-11.080，P〈0.01），ICU多学科床边查房信息化清单的应用缩短了患者机械通气时间和住ICU时间。试验组导管相关性尿路感染的发生率和导管的使用率分别为0（0/6 269）、60.34%（6 269/10 389），对照组分别为0.93‰（6/6 485）、67.02%（6 485/9 676），2组比较差异有统计学意义（χ2=96.187、Fisher精确概率检验=0.031，P〈0.05）。试验组多学科团队合作量表平均分为（3.03 ± 0.11）分，对照组为（4.13 ± 0.39）分，其ICU医务人员多学科合作水平明显提高（t=24.587，P〈0.01）。
结论ICU多学科床边查房信息化清单可提高重症患者的治疗和护理质量以及多学科合作水平，值得在临床推广。
ObjectiveTo investigate the effects of a multidisciplinary round electronic checklist in ICU.
MethodsFrom October 2016 to September 2017, a total of 1 172 patients were provided with a multidisciplinary round electronic checklist. Another 886 patients with routine rounds between October 2015 to September 2016 were retrospectively analyzed. The duration of mechanical ventilation and ICU stay, the rate of nosocomial infection, the percentages of catheter days （central line catheter days, artificial airway days and urinary catheter days） and clinical staffs′ satisfaction with the multidisciplinary collaboration were compared.
ResultsThe duration of mechanical ventilation and ICU stay in the intervention group were 1.42（0.68, 3.63） days and 3.19（2.48, 5.40） days respectively, in the control group were 2.16（1.40, 4.77） days and 4.14（3.46, 6.92） days respectively. The differences between two groups were statistically significant （t=2.084, 2.247, P〈0.05） . The application of a multidisciplinary round electronic checklist shortened the duration of mechanical ventilation and ICU stay. The percentages of catheter days and the rate of catheter-associated urinary tract infection were 0 （0/6 269） , 60.34% （6 269/10 389） respectively, in the control group were 0.93‰ （6/6 485） , 67.02% （6 485/9 676） respectively. The differences between two groups were statistically significant （χ2=96.187, Fisher′s exact test=0.031, P〈0.05） .Besides, the level of multidisciplinary collaboration in ICU was greatly improved in the intervention group, 3.03 ± 0.11 vs. 4.13 ± 0.39 （t=24.587, P 〈 0.05） .
ConclusionsA multidisciplinary round electronic checklist in ICU can improve the care quality and multidisciplinary collaboration.
作者
陈香萍
梁寅
庄一渝
郭丰
陈岳亮
吴银山
黄丽敏
屠骆洋
Chent Xiangping, Liang Yin, Zhuang Yiyu, Guo Feng, Chert Yueliang, Wu Yinshan, Huang Limin, Tu Luoyang(Nursing Department, the Affiliated Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Chin)
出处
《中国实用护理杂志》
2018年第9期672-676,共5页
Chinese Journal of Practical Nursing
基金
浙江省医药卫生科技计划资助项目（2016KYB156）
浙江大学医学院附属邵逸夫医院护理科研基金项目（201505HL）
