Objective To explore the effect of hierarchical nursing mode on the control of infection and prognosis in ICU patients.Methods 84 ICU patients treated at our hospital from January,2014 to January,2017 were randomly divided into a study group and a control group,42 cases for each group.The control group received routine nursing intervention;in addition,the study group were intervened by hierarchical nursing mode.Four weeks after the treatment,both groups were recorded and intervened by nursing management quality score scale.Before and 4 weeks after the treatment,both groups were evaluated by the daily activity of daily life scale.The infection related events in both groups within 4 weeks' intervention were recorded.Results At the end of the fourth week after the intervention,the scores of nursing management,basic nursing care,nursing operation,and nursing program were higher in the study group than in the control group,with statistical differences (all P ＜ 0.05).There were no statistical differences in the Barthel index scores between the two groups before the intervention (all P ＞ 0.05).After the intervention,the study group were better in eating,bathing,modifying,dressing,controlling stool and urine,going to toilet,walking on the ground,walking up and down stairs,moving bed and chair,etc.than the control group,with statistical differences (all P ＜ 0.05).The pathogen colonization rate was 16.7％ (7/42) in the study group,which was lower than that in the control group [45.2％ (19/42)];and the infection rate was 11.9％ (5/42) in the study group,which was lower than that in the control group [33.3％ (14/42)];with statistical differences (P ＜ 0.05).Conclusions The application of hierarchical nursing mode in ICU patients can effectively control the infection status of the body and can improve the disease prognosis,so it is worth being clinically generalized.%目的 探究ICU患者引入层级护理模式对其感染控制情况及病情预后状况的影响.方法 选取本院ICU 2014年1月至2017年1月收治的84例ICU患者,利用随机数字表法分为研究组和对照组,各42例.对照组开展常规护理干预,研究组则在对照组基础上引入层级护理模式.记录两组干预后第4周末接受自制的护理管理质量评分量表;两组均于干预前及干预后第4周末接受日常生活活动能力量表测评;记录两组患者在干预4周内感染相关事件发生情况.结果 干预后第4周末,研究组护理管理、基础护理、护理操作及护理程序质量评分均高于对照组,差异有统计学意义(均P＜ 0.05).两组干预前各项Barthel指数评分差异无统计学意义(均P＞0.05);干预后,研究组患者在进食、洗澡、修饰、穿衣、控制大便、控制小便、上厕所、平地行走、上下楼梯及床椅转移等方面的活动能力评分均高于对照组,差异有统计学意义(均P＜ 0.05).研究组病原菌定植率为16.7％(7/42),低于对照组的45.2％(19/42);研究组病原菌感染率为11.9％(5/42),低于对照组的33.3％(14/42);差异均有统计学意义(均P＜ 0.05).结论 层级护理模式应用于ICU患者,能有效控制机体的感染状况,且能促进病情预后康复,值得在临床上进一步推广.
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