Nogueira Lilia de Souza, Domingues Cristiane de Alencar, Poggetti Renato Sérgio, de Sousa Regina Marcia Cardoso
Medical-Surgical Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil.
Department of Surgery, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
PLoS One. 2014 Nov 6;9(11):e112125. doi: 10.1371/journal.pone.0112125. eCollection 2014.
From the perspective of nurses, trauma patients in the Intensive Care Unit (ICU) demand a high degree of nursing workload due to hemodynamic instability and the severity of trauma injuries. This study aims to identify the factors related to the high nursing workload required for trauma victims admitted to the ICU.
This is a prospective, cross-sectional study using descriptive and correlation analyses, conducted with 200 trauma patients admitted to an ICU in the city of São Paulo, Brazil. The nursing workload was measured using the Nursing Activities Score (NAS). The distribution of the NAS values into tertiles led to the identification of two research groups: medium/low workload and high workload. The Chi-square, Fisher's exact, Mann-Whitney and multiple logistic regression tests were utilized for the analyses.
The majority of patients were male (82.0%) and suffered blunt trauma (94.5%), with traffic accidents (57.5%) and falls (31.0%) being prevalent. The mean age was 40.7 years (± 18.6) and the mean NAS was 71.3% (± 16.9). Patient gender, the presence of pulmonary failure, the number of injured body regions and the risk of death according to the Simplified Acute Physiology Score II were factors associated with a high degree of nursing workload in the first 24 hours following admission to the ICU.
Workload demand was higher in male patients with physiological instability and multiple severe trauma injuries who developed pulmonary failure.
从护士的角度来看,重症监护病房(ICU)中的创伤患者由于血流动力学不稳定和创伤的严重性,需要高度的护理工作量。本研究旨在确定与入住ICU的创伤受害者所需的高护理工作量相关的因素。
这是一项前瞻性横断面研究,采用描述性和相关性分析,对巴西圣保罗市一家ICU收治的200例创伤患者进行。使用护理活动评分(NAS)来衡量护理工作量。将NAS值分布到三分位数中,从而确定了两个研究组:中等/低工作量组和高工作量组。分析采用卡方检验、Fisher精确检验、Mann-Whitney检验和多元逻辑回归检验。
大多数患者为男性(82.0%),遭受钝性创伤(94.5%),交通事故(57.5%)和跌倒(31.0%)较为常见。平均年龄为40.7岁(±18.6),平均NAS为71.3%(±16.9)。患者性别、是否存在肺功能衰竭、受伤身体部位的数量以及根据简化急性生理学评分II得出的死亡风险是入住ICU后最初24小时内与高度护理工作量相关的因素。
生理不稳定且患有肺功能衰竭的男性多重严重创伤患者的工作量需求更高。