责任追究制度及细致化护理在重症监护室患者中的干预效果研究

摘要

Objective To explore the application effect of meticulous nursing intervention combined with accountability system in patients in intensive care unit (ICU),to improve the level of nursing in ICU and ensure the safety of patients.Methods 112 patients in ICU of our hospital during February 2014 and March 2015 were selected as the research object,and randomly divided into study group (56 cases) and control group (56 cases).Control group received routine nursing intervention,while study group received meticulous nursing intervention and accountability system.Compared the rates of risk events and complications of two groups,assessed the psychological state of two groups before and after nursing intervention with Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD),the sleep quality with Pittsburgh Sleep Quality Index (PSQI),and nursing satisfaction degree of patients with self-made satisfaction questionnaire.Results After nursing intervention,the rate of risk events in study group was 0.00％,the rate of complications was 1.79％,those in control group were 10.71％ and 12.50％,with statistically significant differences between two groups (P＜0.05).After nursing intervention,PSQI score in study group was (7.01±1.56),and (11.45±2.15) in control group,with statistically significant difference between two groups (P＜0.01).Before nursing intervention,there were no statistically significant differences in HAMA and HAMD scores between two groups;after nursing intervention,HAMA and HAMD scores in study group were significantly better than those in control group (P＜0.05).The nursing satisfaction rate in study group was 98.21％,and 85.71％ in control group,with statistically significant difference between two groups (P＜0.01).Conclusions Meticulous nursing intervention combined with accountability system in ICU can significantly improve the level of nursing care,reduce the rate of complications,improve the quality of sleep and psychological state of patients,with high patients' satisfaction degree,with high clinical application value of meticulous promotion.%目的 探究细致化护理干预结合责任追究制度在重症监护室患者中的应用效果,旨在提升重症监护室护理水平,确保患者安全.方法 选取我院2014年2月至2015年3月重症监护室收治的1 12例患者作为研究对象,将所有患者采取随机数字表法分为研究组(56例)与对照组(56例),对照组患者采取常规护理干预,研究组采取细致化护理结合责任追究制度进行干预,对比两组患者危险事件发生率及并发症情况,采取汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评估两组患者护理干预前后心理状态,并采取匹茨堡睡眠质量指数量表(PSQI)评估两组患者睡眠质量及本院自制的满意度问卷调查评估患者对护理的满意程度.结果 护理干预后,研究组患者危险事件发生率为0.00％,总并发症率为1.79％,对照组危险事件发生率为10.71％,总并发症率为12.50％,研究组总并发症率及安全事件发生率显著低于对照组,差异有统计学意义(P＜0.05).护理干预后,研究组患者PSQI量表总评分为(7.01±1.56),对照组为(11.45±2.15),差异有统计学意义(P＜0.01).护理干预前,两组患者HAMA、HAND评分对比无统计学差异,护理干预后研究组患者评分改善程度显著优于对照组,差异有统计学意义(P＜0.05).研究组患者护理总满意率为98.21％,对照组为85.71％,差异有统计学意义(P＜0.0l).结论 予以重症监护室患者细致化护理及责任追究制度干预可显著提升护理水平,降低患者并发症率,改善患者睡眠质量及心理状态,患者满意度高,具有较高临床应用价值,可进行细致化推广.