Ayar Ganime, Uysal Yazici Mutlu, Sahin Sanliay, Gunduz Ramiz C, Yakut Halil I, Oden Akman Alkim, Kalkan Gokhan
Hospital Pediátrico de Formación e Investigación en Hematología y Oncología de Angora, Unidad de cuidados intensivos pediátricos. Turkey.
Facultad de Medicina de Hacettepe Üniversitesi, Unidad de cuidados intensivos pediátricos. Turkey.
Arch Argent Pediatr. 2019 Apr 1;117(2):120-125. doi: 10.5546/aap.2019.eng.120.
Recent improvements in pediatric intensive care units (PICUs) were achieved through trained personnel and better technology, leading to an increase in patient care, survival rates and good prognosis. Nevertheless the quality of care varies according to the availability of human and technical resources.
The aim was to determine the correlation of mortality rates with daytime shifts compared to other shift periods (off-hours).
Work hours were defined as week days between 8:00 a.m. and 5:00 p.m., with in-house attendance of senior staff, and off-hours as week days between 5:00 p.m. and 8:00 a.m., weekends and public holidays, with one resident covering the PICU and senior staff directly available only on-call. Mortality causes in children hospitalized in the intensive care unit were classified.
During this period, a total of 2,187 patients were hospitalized in the PICU. A total of 394 patients died; 151 were girls (38.3 %) and 243 boys (61.7 %). Evaluating time of mortality showed that death occurred mostly at out-off hours: 244 (61.9 %) vs. 150 (38.1 %) during the daytime shift, which was statistically significant (p < 0.05). In addition, age, gender and the length of stay in the PICU were not significant (p > 0.05) when daytime was compared to out-off hours. The conditions which accompanied death were evaluated, the relationship between working hours and death was also significant (p < 0.05). More conditions related to mortality were encountered at off-hours.
Off-hours without 24 hour attendance of senior staff, was associated with higher mortality.
儿科重症监护病房（PICUs）近期的改善得益于训练有素的人员和更先进的技术，这使得患者护理、生存率和良好预后都有所提高。然而，护理质量会因人力和技术资源的可获得性而有所不同。
旨在确定与其他轮班时段（非工作时间）相比，白天班次的死亡率之间的相关性。
工作时间定义为工作日上午8:00至下午5:00，期间有高级 staff 在岗值班，非工作时间定义为工作日下午5:00至上午8:00、周末及公共假日，此时只有一名住院医师负责PICU，高级 staff 仅随时待命。对重症监护病房住院儿童的死亡原因进行分类。
在此期间，共有2187名患者入住PICU。共有394名患者死亡；其中151名是女孩（38.3%），243名是男孩（61.7%）。评估死亡时间发现，死亡大多发生在非工作时间：白天班次期间为150例（38.1%），非工作时间为244例（61.9%），具有统计学意义（p < 0.05）。此外，将白天与非工作时间进行比较时，年龄、性别和在PICU的住院时长并无显著差异（p > 0.05）。对伴随死亡的情况进行了评估，工作时间与死亡之间的关系也具有统计学意义（p < 0.05）。在非工作时间遇到的与死亡率相关的情况更多。
高级 staff 非24小时在岗的非工作时间与更高的死亡率相关。
