目的探讨外周中心静脉置管(peripherally inserted central catheter,PICC)过程中脱管的原因,降低脱管的风险。方法对我院近年PICC后发生脱管21例的临床资料进行分析,并根据发生脱管的原因制定预防对策。结果本组发生脱管的原因包括置...目的探讨外周中心静脉置管(peripherally inserted central catheter,PICC)过程中脱管的原因,降低脱管的风险。方法对我院近年PICC后发生脱管21例的临床资料进行分析,并根据发生脱管的原因制定预防对策。结果本组发生脱管的原因包括置管后防范意识缺乏、导管固定方法不正确及固定蝶翼装置丢失、无菌贴膜覆盖不严、护理人员操作失误、带管回家期间出现意外脱管等。结论对置管患者常规进行健康宣教,可以降低PICC脱管的发生,脱管后应实施严谨的操作流程和有效的风险管理。展开更多
目的探讨前馈控制预防脑卒中患者意外拔(脱)管(unp land extubation,UE)的效果。方法回顾分析2010年5月～2011年5月本科室收治的42例脑卒中患者(共置管134例次)UE的风险因素,应用前馈控制方法对2011年6月～2012年6月本科室收治的49例脑...目的探讨前馈控制预防脑卒中患者意外拔(脱)管(unp land extubation,UE)的效果。方法回顾分析2010年5月～2011年5月本科室收治的42例脑卒中患者(共置管134例次)UE的风险因素,应用前馈控制方法对2011年6月～2012年6月本科室收治的49例脑卒中患者(共置管159例次)进行管理。比较前馈控制前后两阶段患者发生UE的情况。结果应用前馈控制后脑卒中患者胃管、深静脉置管、尿管UE的发生率明显下降,前后比较,均P<0.01,差异具有统计学意义。结论对脑卒中患者实施前馈控制管理法,可有效降低UE发生率,确保患者置管安全。展开更多
Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, ...Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1<sup>st</sup> January 2017 and 31<sup>st</sup> December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differ展开更多
文摘目的探讨外周中心静脉置管(peripherally inserted central catheter,PICC)过程中脱管的原因,降低脱管的风险。方法对我院近年PICC后发生脱管21例的临床资料进行分析,并根据发生脱管的原因制定预防对策。结果本组发生脱管的原因包括置管后防范意识缺乏、导管固定方法不正确及固定蝶翼装置丢失、无菌贴膜覆盖不严、护理人员操作失误、带管回家期间出现意外脱管等。结论对置管患者常规进行健康宣教,可以降低PICC脱管的发生,脱管后应实施严谨的操作流程和有效的风险管理。
文摘目的探讨前馈控制预防脑卒中患者意外拔(脱)管(unp land extubation,UE)的效果。方法回顾分析2010年5月～2011年5月本科室收治的42例脑卒中患者(共置管134例次)UE的风险因素,应用前馈控制方法对2011年6月～2012年6月本科室收治的49例脑卒中患者(共置管159例次)进行管理。比较前馈控制前后两阶段患者发生UE的情况。结果应用前馈控制后脑卒中患者胃管、深静脉置管、尿管UE的发生率明显下降,前后比较,均P<0.01,差异具有统计学意义。结论对脑卒中患者实施前馈控制管理法,可有效降低UE发生率,确保患者置管安全。
文摘Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1<sup>st</sup> January 2017 and 31<sup>st</sup> December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differ
