医疗环境设计与重症监护病房不良事件的关联。
Associations between healthcare environment design and adverse events in intensive care unit.
机构信息
Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
出版信息
Nurs Crit Care. 2021 Mar;26(2):86-93. doi: 10.1111/nicc.12513. Epub 2020 May 12.
BACKGROUND
Healthcare environment can affect health. Adverse events (AEs) are common because rapid changes in the patients' status can suddenly arise, and have serious consequences, especially in intensive care. The relationship between the design of intensive care units (ICUs) and AEs has not been fully explored. Hence, an intensive care room was refurbished with cyclic lightning, sound absorbents and unique interior, and exterior design to promote health.
AIMS
The aim of this study was to evaluate the differences between a regular and a refurbished intensive care room in risk for AEs among critically ill patients.
DESIGN
This study retrospectively evaluated associations of AEs and compared the incidence of AEs in patients who were assigned to a multidisciplinary ICU in a refurbished two-bed patient room with patients in the control rooms between 2011 and 2018.
METHODS
There were 1938 patients included in this study (1382 in control rooms; 556 in the intervention room). Descriptive statistics were used to present the experienced AEs. Binary logistic regressions were conducted to estimate the relationship between the intervention/control rooms and variables concerning AEs. Statistical significance was set at P < 0.05.
RESULTS
For the frequency of AEs, there were no significant differences between the intervention room and the control rooms (10.6% vs 11%, respectively, P < 0.805). No findings indicated the intervention room (the refurbished room) had a significant influence on decreasing the number of experienced AEs in critically ill patients.
CONCLUSIONS
The findings revealed a low incident of AEs in both the intervention room as well as in the control rooms, lower than previously described. However, our study did not find any decreases in the AEs due to the design of the rooms.
RELEVANCE TO CLINICAL PRACTICE
Further research is needed to determine the relationship between the physical environment and AEs in critically ill patients.
背景
医疗环境会影响健康。不良事件（AE）很常见，因为患者的病情会突然发生变化，且可能带来严重后果，尤其是在重症监护病房。重症监护病房（ICU）的设计与 AE 之间的关系尚未得到充分探索。因此，翻新了一间重症监护病房，采用了循环闪电、吸声材料和独特的内部和外部设计，以促进健康。
目的
本研究旨在评估常规重症监护病房和翻新后的重症监护病房在重症患者 AE 风险方面的差异。
设计
本研究回顾性评估了 AE 的相关性，并比较了 2011 年至 2018 年期间，在翻新后的两张病床患者病房的多学科 ICU 中分配的患者与对照组患者的 AE 发生率。
方法
本研究共纳入 1938 例患者（对照组 1382 例，干预组 556 例）。采用描述性统计方法呈现所经历的 AE。采用二元逻辑回归分析来估计干预/对照组与 AE 相关变量之间的关系。统计学显著性设为 P < 0.05。
结果
在 AE 频率方面，干预组与对照组之间无显著差异（分别为 10.6%和 11%，P < 0.805）。没有发现干预室（翻新室）对降低重症患者 AE 数量有显著影响。
结论
研究结果显示，干预室和对照组的 AE 发生率均较低，低于之前的报道。然而，我们的研究并未发现由于房间设计而导致 AE 减少的情况。
临床相关性
需要进一步研究以确定重症患者的物理环境与 AE 之间的关系。
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