摘要
目的:探讨ICU护理亚专科管理模式在ICU患者临床救治中的应用效果.方法:基于当前ICU患者的实际需求,制定精准、系统的组织架构、工作流程、联动机制、质控体系、动态跟访、科研转化等管理方案,构建一套护理亚专科多元联动、多向补充、协同发展的双向反馈机制的工作模式.采取类实验方法,将ICU护理亚专科管理模式实施前(2021年1月1日至12月31日)的患者设为对照组,ICU护理亚专科管理模式实施后(2022年1月1日至12月31日)的患者设为干预组,比较实施前后护士的核心能力、专科业务、敏感指标、满意度以及实施前后对患者产生的影响.结果:ICU护理亚专科管理模式实施后提升了护士的核心能力,减少了患者住院时间和机械通气时间,降低患者再入ICU率、ICU获得性衰弱、ICU获得性吞咽障碍、失禁性皮炎的发生率,降低非计划性拔管占比,提高了患者、护士、医生以及学生的满意度,差异均有统计学意义.结论:ICU护理亚专科管理模式的构建,可有效促进ICU护理亚专科建设、护理人员核心能力提升、重塑护理内涵、改善患者预后,最终促进医院护理事业的良性、可持续的发展.
Abstract
Objective:To explore the application effect of ICU nursing sub-specialty management model in the clinical treatment of ICU patients.Methods:Based on the actual needs of ICU patients,a precise and systematic management plan including organizational structure,workflow,linkage mechanism,quality control system,dynamic follow-up,and scientific research transformation was formulated,to construct a working model of multi-linkage,multi-direction supplement and coordinated development of two-way feedback mechanism in sub-specialty nursing.The control group was set before the implementation of ICU nursing sub-specialty management mode(Jan 1 to Dec 31,2021),and the intervention group was set after the implementation of ICU nursing sub-specialty management model(Jan 1 to Dec 31,2022).The core competence,specialty,sensitive indicators,satisfaction,and impact on patients were compared before and after implementation.Results:After the implementation of the ICU nursing sub-specialty management model,the core competence of nurses was improved,and the hospitalization time and mechanical ventilation time of patients were reduced,the incidence of re-entry ICU,acquired weakness,acquired dysphagia and incontinence dermatitis was decreased,the proportion of unplanned extubation was decreased,and the satisfaction of patients,nurses,doctors and students was improved(P＜0.05).Conclusion:The construction of ICU nursing sub-specialty management model can effectively promote the construction of ICU nursing sub-specialty,improve the core competence of nurses,reshape the connotation of nursing,improve the prognosis of patients,and ultimately promote the benign and sustainable development of hospital nursing.
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