患者重返ICU的原因分析及护理干预

摘要

Objective:To analyze the causes of returning to ICU of 79 patients,to probe into the measures of diminishing the number of returning patients by nursing intervention.Method:We collected the clinical data of patients who checked in ICU for two times or more,we recorded their clinical characteristics and the causes of returning to ICU,then we analyzed the influencing factors.Result:In the 3760 patients who checked in ICU,there were 79 patients returning to ICU,The return rate is 2.1%;the main reasons were respiratory(51.9%)or cardiovascular(17.7%)ailments;the influencing factors were associated with artificial airway,the duration of mechanical ventilation,APS,acquired pneumonia in hospital and chronic diseases. Conclusion:The main reason of returning to ICU in general wards is lack of The follow-up care,so assessment of patients before shift to general wards, detailed guidance to general wards,nursing care of patients with airway,training in hospitals,nursing consultation,communication and education to patients and family members all have important influence on the returning rate to ICU.%　　目的：总结分析79例患者重返ICU的原因,探讨能否通过护理干预措施减少患者重返的方法.方法：收集2009年1月-2011年12月入住ICU≥2次的病例资料,记录这些患者的临床特征,重返ICU的原因,通过资料分析重返ICU的影响因素.结果：在3760例入住ICU的患者中,共有79例重返ICU,重返率为2.1%；重返ICU的主要原因为呼吸道(51.9%)和心血管(17.7%)方面的问题；重返ICU的影响因素与人工气道、机械通气时间、出科时的APS、医院内感染性肺炎、入科时伴有慢性疾病密切相关.结论：普通病房缺乏后续的加强监护是患者重返ICU的主要原因,转科前全面评估患者病情,转科时详细交待和指导,加强患者气道护理,进行院内培训和护理会诊,加强患者与家属的沟通与宣教,对防止患者重返有重要的影响.