Castellan Cristiana, Sluga Silvia, Spina Eleonora, Sanson Gianfranco
Emergency Department, University Hospital of Trieste, Italy.
"Maggiore" Intensive Care Unit, University Hospital of Trieste, Italy.
J Adv Nurs. 2016 Jun;72(6):1273-86. doi: 10.1111/jan.12913. Epub 2016 Feb 9.
To describe the nursing diagnoses, outcomes and interventions for patients admitted to intensive care units and to assess their possible relation with classical outcomes like length of stay and mortality.
The analysis of nursing diagnosis frequencies may help to estimate the patients' complexity and the need for nursing interventions and can predict hospital outcomes. Nonetheless, few studies were conducted on critical patients.
Prospective cohort observational study.
Between 15 July-31 October 2013 we collected the above-described nursing parameters of 100 subjects throughout their stay in intensive care. We classified the parameters according to established taxonomies. The independent association between the number of nursing diagnoses and length of stay/mortality was investigated with multiple regressions.
We found an average of 19 diagnoses, 24 outcomes and 60 interventions per patient. Most frequently, the plans of care involved support for self-care deficits or interrupted family processes. They also included strategies to prevent infection, disuse syndrome and impairment of skin integrity. Nineteen nursing diagnoses were significantly related with mortality or length of stay in bivariate analyses. In regression models, the number of such diagnoses explained 29·7% of the variance in length of stay and was an independent predictor of mortality.
In critically ill patients, the analysis of nursing diagnoses, outcomes and interventions confirmed an intense activity in response to a broad spectrum of patient needs. The number of nursing diagnoses allowed to predict patient outcomes.
描述入住重症监护病房患者的护理诊断、结局及干预措施，并评估其与住院时间和死亡率等经典结局之间的可能关系。
对护理诊断频率的分析有助于估计患者的复杂程度以及护理干预的需求，并可预测医院结局。然而，针对危重症患者的研究较少。
前瞻性队列观察性研究。
在2013年7月15日至10月31日期间，我们收集了100名受试者在重症监护期间的上述护理参数。我们根据既定分类法对这些参数进行分类。采用多元回归研究护理诊断数量与住院时间/死亡率之间的独立关联。
我们发现每位患者平均有19项诊断、24项结局和60项干预措施。护理计划最常涉及对自理缺陷或家庭过程中断的支持。还包括预防感染、废用综合征和皮肤完整性受损的策略。在双变量分析中，19项护理诊断与死亡率或住院时间显著相关。在回归模型中，此类诊断的数量解释了住院时间方差的29.7%，并且是死亡率的独立预测因素。
在危重症患者中，对护理诊断、结局及干预措施的分析证实了针对广泛患者需求的密集活动。护理诊断的数量能够预测患者结局。
