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护士对慢性危重症患者临床结局预测的准确性

The Accuracy of Nurses' Predictions for Clinical Outcomes in the Chronically Critically Ill.

作者信息

Lipson Amy R, Miano Sarah J, Daly Barbara J, Douglas Sara L

机构信息

FPB School of Nursing, Case Western Reserve University, USA.

出版信息

Res Rev J Nurs Health Sci. 2017 Sep;3(2):35-38. Epub 2017 Jul 25.

PMID:28936495
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5603073/
Abstract

BACKGROUND

Accurately predicting survivorship of patients in the intensive care unit is known to be difficult. Previous research has shown that nurses are more likely to recognize futile medical care than other disciplines. The purpose of this study was to describe the accuracy of nurse's predictions for survival of patients who are chronically critically ill (CCI).

METHODS

Using a secondary data analysis from a longitudinal, descriptive study, we evaluated nurses' predictions for survival at admission and until ICU discharge or patient death.

RESULTS

Nurses were able to more accurately predict survival of CCI patients than death and prognostication appeared to improve with prolonged ICU stays.

CONCLUSION

This is the first longitudinal study that focused on nurse prognostication in a chronically critically ill patient population. Future research should explore the relationship between ICU nurse characteristics and the accuracy of survival predictions.

摘要

背景

众所周知,准确预测重症监护病房患者的存活率很困难。先前的研究表明,与其他学科相比,护士更有可能识别出无效的医疗护理。本研究的目的是描述护士对慢性危重症(CCI)患者生存预测的准确性。

方法

我们使用一项纵向描述性研究的二次数据分析,评估护士对患者入院时以及直至重症监护病房出院或患者死亡时生存情况的预测。

结果

护士能够比预测死亡更准确地预测CCI患者的生存情况,并且随着在重症监护病房住院时间的延长,预后似乎有所改善。

结论

这是第一项关注慢性危重症患者群体中护士预后判断的纵向研究。未来的研究应探索重症监护病房护士的特征与生存预测准确性之间的关系。

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本文引用的文献

1
Is 'gut feeling' by medical staff better than validated scores in estimation of mortality in a medical intensive care unit? - The prospective FEELING-ON-ICU study.医护人员的“直觉”是否优于经验证的评分,用于预测重症监护病房的死亡率?-前瞻性 FEELING-ON-ICU 研究。
J Crit Care. 2017 Oct;41:204-208. doi: 10.1016/j.jcrc.2017.05.029. Epub 2017 May 25.
2
Discriminative Accuracy of Physician and Nurse Predictions for Survival and Functional Outcomes 6 Months After an ICU Admission.重症监护病房(ICU)入院6个月后医生和护士对生存及功能转归预测的判别准确性
JAMA. 2017 Jun 6;317(21):2187-2195. doi: 10.1001/jama.2017.4078.
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Complexity Analysis of Decision-Making in the Critically Ill.危重病患者决策的复杂性分析。
J Intensive Care Med. 2018 Oct;33(10):557-566. doi: 10.1177/0885066616678394. Epub 2016 Nov 20.
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Concordance of Nurses and Physicians on Whether Critical Care Patients are Receiving Futile Treatment.护士与医生在重症监护患者是否接受无效治疗问题上的一致性。
Am J Crit Care. 2015 Sep;24(5):403-10. doi: 10.4037/ajcc2015476.
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Power and limitations of daily prognostications of death in the medical ICU for outcomes in the following 6 months.医学重症监护病房中每日死亡预后对接下来6个月预后情况的预测能力及局限性。
Crit Care Med. 2014 Nov;42(11):2387-92. doi: 10.1097/CCM.0000000000000521.
6
Comparative multidisciplinary prediction of survival in patients with advanced cancer.比较多学科预测晚期癌症患者的生存情况。
Support Care Cancer. 2014 Mar;22(3):611-7. doi: 10.1007/s00520-013-2013-2. Epub 2013 Oct 18.
7
Research priorities for geriatric palliative care: goals, values, and preferences.老年姑息治疗的研究重点:目标、价值观和偏好。
J Palliat Med. 2013 Oct;16(10):1175-9. doi: 10.1089/jpm.2013.9475. Epub 2013 Sep 5.
8
Consistency of nurses' daily predictions of survival in the intensive care.护士对重症监护患者每日生存情况预测的一致性。
Stud Health Technol Inform. 2012;180:1060-4.
9
Trauma intensive care unit survival: how good is an educated guess?创伤重症监护病房的生存率:凭经验猜测的准确性如何?
J Trauma. 2010 Jun;68(6):1279-87; discussion 1287-8. doi: 10.1097/TA.0b013e3181de3b99.
10
Supporting hope and prognostic information: nurses' perspectives on their role when patients have life-limiting prognoses.支持希望和预后信息:护士在患者预后有限时对其角色的看法。
J Pain Symptom Manage. 2010 Jun;39(6):982-92. doi: 10.1016/j.jpainsymman.2009.11.315.