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重症监护病房联络护士对长时间入住重症监护病房患者出院延迟的影响。

The impact of an ICU liaison nurse on discharge delay in patients after prolonged ICU stay.

作者信息

Chaboyer W, Thalib L, Foster M, Elliott D, Endacott R, Richards B

机构信息

Research Centre for Clinical Practice Innovation, Griffith University Gold Coast Campus, Bundall, Queensland.

出版信息

Anaesth Intensive Care. 2006 Feb;34(1):55-60. doi: 10.1177/0310057X0603400101.

Abstract

The mismatch between intensive care unit (ICU) bed availability and demand may be improved with timely patient discharges, however little is known about the nature and contributing factors of discharge delays. This study investigated the impact of a specific intervention--the ICU liaison nurse role--in reducing ICU discharge delay using a prospective block intervention study. One hundred and eighty-six ICUpatients (101 control and 85 liaison nurse intervention) with an ICU length of stay of three days or longer and who survived to ICU discharge were examined. The liaison nurse was involved in assessment of patients for transfer to the ward, with a major focus on coordinating patient transfer including liaison with ward staff prior to and following ICU discharge. Logistic regression was used to quantify the risk of discharge delay associated with the liaison nurse intervention with adjustment for potential confounding variables. While no demographic or clinical variables were significant predictors of ICU discharge delay, those in the liaison nurse group were almost three times less likely to experience a discharge delay of at least two hours and about 2.5 times less likely to experience a delay of four or more hours. The positive effect of the liaison nurse role in reducing the discharge delay remained after adjustingforpotential confounders. We conclude that the liaison nurse role is effective in reducing the discharge delay in ICU transfer

摘要

通过及时让患者出院,重症监护病房(ICU)床位供应与需求之间的不匹配情况可能会得到改善,然而,关于出院延迟的性质和促成因素却知之甚少。本研究采用前瞻性整群干预研究,调查了一种特定干预措施——ICU联络护士角色——对减少ICU出院延迟的影响。研究考察了186名入住ICU达三天或更长时间且存活至ICU出院的患者(101名对照组患者和85名接受联络护士干预的患者)。联络护士参与评估患者转往病房的情况,主要重点是协调患者转院事宜,包括在ICU出院前后与病房工作人员进行联络。采用逻辑回归分析,在对潜在混杂变量进行调整后,量化与联络护士干预相关的出院延迟风险。虽然没有人口统计学或临床变量是ICU出院延迟的显著预测因素,但联络护士组的患者经历至少两小时出院延迟的可能性几乎低三倍,经历四小时或更长时间延迟的可能性低约2.5倍。在对潜在混杂因素进行调整后,联络护士角色在减少出院延迟方面的积极作用依然存在。我们得出结论,联络护士角色在减少ICU转院时的出院延迟方面是有效的。

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