重症监护护理认证护士专家担任护士长对 ICU 患者结局的影响。
Impact of having a certified nurse specialist in critical care nursing as head nurse on ICU patient outcomes.
机构信息
Faculty of Nursing, Kyoritsu Women's University, Tokyo, Japan.
Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
出版信息
PLoS One. 2020 Feb 5;15(2):e0228458. doi: 10.1371/journal.pone.0228458. eCollection 2020.
Abstract
OBJECTIVES
This study evaluated the impact of the presence of a certified nurse specialist in critical care (CNS) as ICU head nurse in an open ICU on clinical outcomes.
METHODS
The presence of a CNS as ICU head nurse was implemented in practice in April 2017. To evaluate the impact on patient outcomes before and after the implementation, patients were divided into two groups: before (April 2014 to March 2017; 1988 patients) and after (April 2017 to March 2019; 1664 patients). Patients' demographic data were collected from the ICU database.
RESULTS
Multivariable logistic regression analysis revealed that the presence of a CNS as ICU head nurse was associated with lower ICU mortality (odds ratio (OR): 0.52, 95% CI: 0.36-0.73, p < .001) and fewer patients receiving mechanical ventilation in the ICU (OR: 0.20, 95% CI: 0.15-0.26, p < .001).
CONCLUSION
CNSs are defined as one type of advanced practice nurses. Having a CNS as a head nurse in the ICU may have helped improve patient outcomes by leveraging these practical skills in nursing management.
摘要
目的
本研究评估了在开放式 ICU 中，重症监护认证护士专家（CNS）担任 ICU 护士长对临床结局的影响。
方法
2017 年 4 月，在实践中实施了 CNS 担任 ICU 护士长的方案。为了评估实施前后对患者结局的影响，将患者分为两组：实施前（2014 年 4 月至 2017 年 3 月；1988 例）和实施后（2017 年 4 月至 2019 年 3 月；1664 例）。患者的人口统计学数据从 ICU 数据库中收集。
结果
多变量逻辑回归分析表明，CNS 担任 ICU 护士长与 ICU 死亡率降低相关（比值比（OR）：0.52，95%置信区间（CI）：0.36-0.73，p <.001），且 ICU 接受机械通气的患者减少（OR：0.20，95% CI：0.15-0.26，p <.001）。
结论
CNS 被定义为一种高级实践护士。在 ICU 中让 CNS 担任护士长可能有助于通过利用这些护理管理方面的实践技能来改善患者结局。
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