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实施计算机化移动医嘱集和重症监护病房移动协议后,外科重症监护病房的患者移动性增加:一项前瞻性队列分析。

Surgical intensive care unit mobility is increased after institution of a computerized mobility order set and intensive care unit mobility protocol: a prospective cohort analysis.

作者信息

Hildreth Amy N, Enniss Toby, Martin Robert S, Miller Preston R, Mitten-Long Donna, Gasaway Janice, Ebert Fran, Butcher Wendy, Browder Kevin, Chang Michael C, Hoth Jason J, Mowery Nathan T, Meredith J W

机构信息

Department of Surgery, Wake Forest University, Winston-Salem, North Carolina 27157, USA.

出版信息

Am Surg. 2010 Aug;76(8):818-22.

Abstract

In some populations, intensive care unit (ICU) mobility has been shown to be safe and beneficial. We gathered data on 50 nonintubated surgical patients in a 10-bed surgical ICU (SICU) who met physiologic inclusion criteria beginning in May 2008 (A group). In January 2009, we began mandatory entry of computerized mobility orders as part of a standardized ICU order set. We also created a mobility protocol for nurses in this ICU. We then collected data on 50 patients in this postintervention cohort (B group). Both groups had similar baseline characteristics. A group patients had some form of mobility orders entered in 29 patients (58%) versus 47 patients (82%) in the B group, P < 0.05. In the A group, 11 patients (22%) were mobilized; in the B group, 40 patients (80%) were mobilized, P < 0.05. In our SICU patient population, mandatory entry of computerized mobility orders as part of a standard SICU order set and establishment of an ICU mobility nursing protocol was associated with an increase in number of mobility orders entered as well as an increase in SICU patient activity. Further studies should focus on measurement of the effect of mobility interventions on patient outcomes.

摘要

在一些人群中,重症监护病房(ICU)活动已被证明是安全且有益的。我们收集了自2008年5月起在一间拥有10张床位的外科重症监护病房(SICU)中符合生理纳入标准的50例非插管手术患者的数据(A组)。2009年1月,我们开始将计算机化的活动医嘱作为标准化ICU医嘱集的一部分强制录入。我们还为该ICU的护士制定了一项活动方案。然后我们收集了该干预后队列中50例患者的数据(B组)。两组具有相似的基线特征。A组中有29例患者(58%)录入了某种形式的活动医嘱,而B组中有47例患者(82%)录入了活动医嘱,P<0.05。在A组中,11例患者(22%)进行了活动;在B组中,40例患者(80%)进行了活动,P<0.05。在我们的SICU患者群体中,将计算机化的活动医嘱作为标准SICU医嘱集的一部分强制录入以及制定ICU活动护理方案与录入的活动医嘱数量增加以及SICU患者活动量增加相关。进一步的研究应侧重于衡量活动干预对患者结局的影响。

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