Alberto Laura, Zotárez Haydeé, Cañete Ángel Alberto, Niklas José Emilio Baca, Enriquez José Marcelino, Gerónimo Mario Rolando, Martínez María del Carmen, Chaboyer Wendy
Nursing Department, Sanatorio de Alta Complejidad Sagrado Corazón, Ciudad Autónoma de Buenos Aires, Argentina; Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast, Australia.
Intensive Crit Care Nurs. 2014 Feb;30(1):31-7. doi: 10.1016/j.iccn.2013.07.001. Epub 2013 Aug 17.
Recognising and responding to clinical deterioration in hospital patients has been promoted by many western countries to improve patient safety. In non-western and developing countries it is likely to be even more important to focus on strategies of patient safety. This paper reflects the services provided by Intensive Care Unit Liaison Nurses (ICULN) in the first year of their work, July 2010-June 2011, in an Argentinean hospital.
This practice audit aimed to describe the ICULN patient care activities performed for patients discharged from the ICU and ward patients with complex care needs, and to identify education activities carried with ward nursing staff caring for these patients.
Experienced critical care nurses, with strong communication and education skills were appointed as ICULNs. They were asked to assess ward patients transferred from ICU once per shift and ward patients as requested by staff. They had to provide patient complex care if necessary and education to ward nurses caring for these patients.
A total of 387 patients were followed by ICULNs. The median age of patients was 49 (IQR 26) years (range 15-89). A total of 369 (95.3%) of the patients were discharged from ICU and 18 (4.7%) were ward patients who required complex care. The most frequent conditions patients had were surgery, neurologic conditions, trauma and sepsis. Thirty four (9.2%) of 369 patients who were initially in ICU, were readmitted during the same hospitalisation. During the study period ICULNs performed 5973 patient care and 1709 staff education activities.
ICULNs provide advanced assessment and surveillance of ICU discharged and complex ward patients, and facilitate ICU-ward transition assisting and educating ward staff. Further evaluation is necessary to better describe the role in Argentina and the effect of ICULN service on patient outcomes and on staff.
许多西方国家都在推动对医院患者临床病情恶化的识别与应对,以提高患者安全。在非西方国家和发展中国家,关注患者安全策略可能更为重要。本文反映了重症监护病房联络护士(ICULN)在2010年7月至2011年6月于一家阿根廷医院工作的第一年所提供的服务。
本次实践审核旨在描述ICULN为从重症监护病房出院的患者以及有复杂护理需求的病房患者所开展的护理活动,并确定针对护理这些患者的病房护理人员所进行的教育活动。
经验丰富、具备较强沟通和教育技能的重症护理护士被任命为ICULN。要求他们每班对从重症监护病房转来的病房患者进行一次评估,并应工作人员要求对病房患者进行评估。如有必要,他们必须为患者提供复杂护理,并对护理这些患者的病房护士进行教育。
ICULN共跟踪了387名患者。患者的中位年龄为49(四分位间距26)岁(范围15 - 89岁)。共有369名(95.3%)患者从重症监护病房出院,18名(4.7%)是需要复杂护理的病房患者。患者最常见的病情是手术、神经系统疾病、创伤和败血症。最初在重症监护病房的369名患者中有34名(9.2%)在同一住院期间再次入院。在研究期间,ICULN开展了5973次患者护理和1709次工作人员教育活动。
ICULN为从重症监护病房出院的患者和复杂的病房患者提供高级评估和监测,并促进重症监护病房与病房之间的过渡,协助和教育病房工作人员。有必要进行进一步评估,以更好地描述ICULN在阿根廷的作用以及ICULN服务对患者结局和工作人员的影响。