Massey Debbie, Aitken Leanne M, Wendy Chaboyer
Griffith University, Kessels Road, Nathan, Qld, Australia.
Aust Crit Care. 2008 Aug;21(3):127-40. doi: 10.1016/j.aucc.2008.05.051. Epub 2008 Jul 16.
As technological developments continue to offer patients more health care choices patient acuity increases. Patients that traditionally would have been cared for in a critical care environment are increasingly located on general wards. This change impacts on the acute care sector in a number of ways. Patients who are inpatients have more complex problems and a greater number of co-morbidities and are therefore more likely to suffer physiological deterioration. Procedures requiring inpatient stays are often more complex and associated with higher rates of mortality and morbidity. As patient acuity has increased research has highlighted that the care of the acutely ill ward patient is suboptimal. Suboptimal care implies a lack of knowledge regarding the significance of clinical findings relating to dysfunction of airway, breathing and circulation. This paper analyses the literature on the factors that contribute to suboptimal ward care of the acutely ill patient. It uses the categories proposed by McQuillan et al. (1998) in relation to suboptimal ward care in an attempt to develop a conceptual analysis of the factors that influence suboptimal ward care and acutely ill ward patients. Thus it aims to develop and enhance practitioners' knowledge and understanding of this topic and therefore improve patient care outcomes.
随着技术发展持续为患者提供更多医疗保健选择，患者病情严重程度增加。传统上会在重症监护环境中接受治疗的患者越来越多地住在普通病房。这一变化在多个方面对急症护理部门产生影响。住院患者有更复杂的问题和更多的合并症，因此更有可能出现生理机能恶化。需要住院治疗的程序通常更复杂，且死亡率和发病率更高。随着患者病情严重程度的增加，研究表明对急症病房患者的护理并不理想。护理不理想意味着对与气道、呼吸和循环功能障碍相关的临床发现的重要性缺乏了解。本文分析了有关导致对急症患者病房护理不理想的因素的文献。它采用了麦奎兰等人（1998年）提出的与不理想病房护理相关的类别，试图对影响不理想病房护理和急症病房患者的因素进行概念分析。因此，其目的是发展和增强从业者对该主题的知识和理解，从而改善患者护理结果。
