目的 探讨重症监护病房实施分级护理制度对重症颅脑外伤患者院内感染发生率及ICU入住时间的影响.方法 选择医院ICU收治的重症颅脑外伤患者108例,随机将其分为实验组和对照组,实验组55例根据APACHEⅡ评分结果对患者进行分级护理,对照组53例进行ICU常规护理,观察2组患者在ICU住院时间、院内感染发生率、患者病死率及出院后护理质量调查及满意度评分.结果 实验组的基础护理、护理技能、病房管理、健康教育、护理流程分值均明显高于对照组(P＜0.05);实验组院内感染发生率、病死率、ICU入住时间均明显低于对照组,差异均有统计学意义(P＜0.05);实验组对护理工作不满意的人数明显低于对照组,满意的人数明显高于对照组,差异有统计学意义(P＜0.01).结论 应用分级护理模式的重症颅脑外伤患者的院内感染情况、病死率及ICU入住时间显著低于应用常规护理模式的重症颅脑外伤患者,分级护理能更好地为患者提供优质护理服务,改善ICU的护理工作水平,提高患者对护理工作的满意度.%Objective To investigate the effect of grading nursing system in intensive care unit on the incidence of nosocomial infection and the length of ICU stay in patients with severe traumatic brain injury.Methods A total of 108 patients with severe craniocerebral trauma were randomly divided into experimental group and control group,55 cases in the experimental group were given grading nursing care according to the APACHE score results and 53 patients in the control group were given ICU routine nursing.Hospitalization time,infection rate in ICU,mortality and nursing quality satisfaction score were compared.Results The basic nursing,nursing skills,ward management,health education,nursing process scores of experimental group were significantly higher than the control group (P ＜ 0.05);The infection rate,mortality rate,the hospitalization time in ICU were significantly lower than the control group (P ＜ 0.05);Unsatisfied patients towards nursing work was significantly lower than the control group,the number of satisfied patients towards nursing work was significandy higher than the control group (P ＜ 0.01).Conclusion Grading nursing mode for patients with severe craniocerebral trauma has lower hospital infection,the mortality rate and shorter ICU time than that of conventional nursing mode,and it can provide better care for patients,improve the ICU nursing level and patients'satisfaction with nursing work.
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