“安全·支持·合作”过渡期护理模式在ICU转出患者中的应用

摘要

目的:探讨分析“安全.支持.合作”(secure,encourage,and collaboration,SEC)过渡期护理模式在ICU转出患者的应用效果,为提升重症患者的临床护理质量提供临床依据.方法:选择2015年1至12月在宜兴市人民医院ICU住院的93名患者作为对照组,按照常规的操作程序进行转科护理,选择2016年1至12月的97名患者作为观察组,实施以ICU联络护士(ICU liaison nurses,ICULN)为介导的SEC过渡期护理模式进行干预,评估并比较两组的过渡期护理措施评估表(care transitions measure,CTM)、干预前后的心理状态、家属满意度、患者满意度、接诊医护人员满意度、72 hICU重返率及平均住院日.结果:两组患者干预前后焦虑自评量表(self-rating anxiety scale,SAS)及抑郁自评量表(self-rating depression scale,SDS)评分均有明显改善(P＜0.05),且观察组患者改善程度更为显著(P＜0.05);观察组在CTM各条目的得分、家属满意度、患者满意度及接诊医护人员满意度均明显高于对照组,在72 h ICU重返率及平均住院日明显低于对照组(P＜0.05).结论:SEC过渡期护理模式有利于提升过渡期的护理质量,降低负性心理,提高患者、家属及接诊医护人员的满意度,且能在一定程度上改善临床治疗结局.%Objective:To explore and analyse the application effects of secure,encourage,and collaborate (SEC) transitional nursing model on patients discharged from ICU,and to provide the evidence of clinical nursing quality to patients with severe illnesses.Methods:Ninety-three patients,who had been hospitalized in the ICU of our hospital from January to December 2015,were selected as the objects in the control group.They were transferred to the general ward according to traditional procedures.Ninety-seven patients,who had been hospitalized in the ICU of our hospital from January to December 2016,were selected as the objects in the observation group.They adopted SEC transitional nursing model with ICU liaison nurses (ICULN).Then we valuated and compared the two groups in the aspects of scores of care transitions measure (CTM),their mental states before and after the intervention,families' satisfaction,patients' satisfaction,the satisfaction of medical staff receiving patients,72 h ICU readmissionrate and the average length of stay.Results:Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) of the two groups before and after the intervention improved significantly (P＜0.05),and more significantly in the observation group (P＜0.05);as for the scores of CTM,families' satisfaction,patients' satisfaction and the satisfaction of medical staff receiving patients,the scores of the observation group were much higher than those of the control group;as for the scores of 72 h ICU readmission rate and the average length of stay,scores of the observation group were much lower than those of control group (P＜0.05).Conclusion:The SEC transitional nursing model is helpful to improve the nursing quality in the transitional period,reduce the negative mental states of patients,improve the satisfaction of patients,family members and medical staff,and improve the clinical outcome to a certain degree.