谵妄与心内科重症监护病房患者的危险因素的关系与护理工作量有关。
The relationship of delirium and risk factors for cardiology intensive care unit patients with the nursing workload.
机构信息
Ankara University Faculty of Health Sciences, Ankara, Turkey.
出版信息
J Clin Nurs. 2018 May;27(9-10):2109-2119. doi: 10.1111/jocn.14365.
AIMS AND OBJECTIVES
To evaluate the relationship of delirium and risk factors for cardiology intensive care unit (ICU) patients with the nursing workload.
BACKGROUND
Delirium is a common syndrome in patients with cardiac problems. The risk factors causing delirium and the presence and type of delirium affect the nurse workload and patient care quality adversely.
DESIGN
This cross-sectional study was conducted with 133 patients staying at the cardiology ICU of a university hospital between 5 January-31 March 2017.
METHOD
The study data were collected using the Patient Information Form, Delirium Risk Factors' Form and Therapeutic Intervention Scoring System-28 (TISS-28) scale to identify the nurse workload. The statistical analysis of the data was performed using frequency, chi-square, Mann-Whitney U, correlation and regression analyses.
RESULTS
It was found that patients who developed delirium were 65 years or older, they had more nasogastric/total parenteral nutrition (NG/TPN), benzodiazepine and physical restraints in comparison with those with no delirium development, and that the prevalence of hypoxia and hypoalbuminemia were higher in these patients. The mean TISS-28 score was higher in patients with delirium, compared with those without delirium. There was a positive correlation between the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and the mean TISS-28 score of the patients. The mean TISS-28 score was found to significantly increase with being at the age of 65 and above and the administration of mechanical ventilation. The patients with delirium required a mean of 60-min additional care.
CONCLUSIONS
Our study results suggest that the presence of delirium and the delirium risk factors, irrespective of delirium, increase the nurse workload.
RELEVANCE TO CLINICAL PRACTICE
An effective management of delirium risk factors can improve the patient care quality by reducing delirium occurrence and nurse workload.
目的和目标
评估心内科重症监护病房（ICU）患者谵妄与危险因素的关系及其对护理工作量的影响。
背景
谵妄是心脏病患者的常见综合征。导致谵妄的危险因素以及谵妄的发生和类型会对护士的工作量和患者护理质量产生不利影响。
设计
本横断面研究于 2017 年 1 月 5 日至 3 月 31 日期间在一所大学医院的心内科 ICU 对 133 名患者进行。
方法
使用患者信息表、谵妄危险因素表和治疗干预评分系统-28 （TISS-28）量表收集研究数据，以确定护士的工作量。数据分析采用频率、卡方检验、Mann-Whitney U 检验、相关性和回归分析。
结果
研究发现，与无谵妄发生的患者相比，发生谵妄的患者年龄在 65 岁或以上，有更多的鼻胃管/全胃肠外营养（NG/TPN）、苯二氮䓬类药物和身体约束，这些患者缺氧和低白蛋白血症的发生率更高。与无谵妄的患者相比，谵妄患者的 TISS-28 评分平均值更高。患者的平均急性生理学和慢性健康评估 II （APACHE II）评分与 TISS-28 评分呈正相关。TISS-28 评分均值随着年龄在 65 岁及以上和机械通气的使用而显著增加。谵妄患者需要额外的 60 分钟护理。
结论
本研究结果表明，谵妄的存在以及无论是否存在谵妄，其危险因素都会增加护士的工作量。
临床相关性
有效管理谵妄的危险因素可以通过减少谵妄的发生和护士的工作量来提高患者的护理质量。
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