美国儿科心血管危重症护理：护理和组织特点。

Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, MA 02115, USA.

Am J Crit Care. 2012 Jul;21(4):242-50. doi: 10.4037/ajcc2012853.

BACKGROUND

Nursing and organizational characteristics influence patients' outcomes. Little is known about nursing structure and process supports in the intensive care units of children's hospitals. Objectives To describe and understand nursing and organizational characteristics of cardiovascular care in children's hospitals.

METHODS

Descriptive analyses were used to identify and describe nursing and unit characteristics of 43 children's hospitals. An electronic survey instrument was designed to elicit data from nurse leaders.

RESULTS

Nursing and unit parameters varied significantly. Most registered nurses (70%) had baccalaureate degrees and worked full time. Every intensive care unit had nurses with specialty certification. A total of 51% of nurses had 5 or fewer years of clinical experience. Indirect resources also varied. Unit secretaries were employed by 98% of units, and 100% had a nurse manager and/or a director plus an attending physician. A total of 77% of the units had advanced practice nurses. Processes of care included checklists in 100% of the units, standardized communication in 95%, quality metrics in 91%, and nurse-developed algorithms in 44%. Among the units, 56% had Magnet recognition, and 3 were recipients of a Beacon Award.

CONCLUSION

Cardiovascular intensive care varies widely across children's hospitals. Opportunities exist for support and retention of an intergenerational nursing workforce. These findings may serve as a contemporary benchmarking source and foundation to standardize models of care, support, and resource utilization in pediatric intensive care units.

背景

护理和组织特征会影响患者的治疗结果。目前，人们对儿童医院重症监护病房的护理结构和流程支持知之甚少。目的：描述和了解儿童医院心血管护理的护理和组织特征。

方法

采用描述性分析方法，确定并描述了 43 家儿童医院的护理和科室特征。设计了电子调查工具，以从护理负责人那里收集数据。

结果

护理和科室参数差异显著。大多数注册护士（70%）拥有学士学位并全职工作。每个重症监护病房都有具有专业认证的护士。共有 51%的护士临床经验不足 5 年。间接资源也存在差异。98%的科室都有科室秘书，100%的科室都有护士经理和/或主任加主治医生。共有 77%的科室有高级执业护士。护理流程包括 100%的科室使用检查表、95%的科室使用标准化沟通、91%的科室使用质量指标和 44%的科室使用护士制定的算法。在这些科室中，56%的科室获得了 Magnet 认证，有 3 个科室获得了 Beacon 奖。