Department of Intensive Care Unit (Eastern), Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China.
Department of Intensive Care Unit (Western), Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China.
Comput Math Methods Med. 2022 May 14;2022:3330667. doi: 10.1155/2022/3330667. eCollection 2022.
Multivariate logistic analysis was employed to explore the risk factors of safety risks in the transport of critically ill patients with ICU and the improvement of nursing strategies.
Two hundred critical transport patients with ICU treated in our hospital from January 2019 to April 2021 were enrolled. According to the occurrence of unsafe events in transit, the patients were assigned to the control group (165 cases without unsafe events, = 165) and the study group (35 cases with safety incidents, = 35). Multivariate logistic analysis was employed to explore the risk factors of safety risks in the transport of critically ill patients with ICU and to enhance nursing strategies.
(1) General data of the subjects: among the 200 critically ill patients with ICU who needed in-hospital transport, the age ranged from 18 to 85 years with an average age of 52.48 ± 3.31, including 89 males and 111 females. There were 35 cases of gastrointestinal bleeding, 16 cases of respiratory failure, 23 cases of heart failure, 43 cases of myocardial infarction, 26 cases of cerebrovascular accident, 14 cases of ectopic pregnancy, 25 cases of severe injury, and 18 cases of mechanical ventilation. There were 35 cases in the study group with accidents and 45 cases in group B without accidents. (2) Among the 200 patients, 35 patients had complications during the transit process in the intermediate people's court, with an incidence rate of 17.5%. It included blood pressure fluctuation ( = 6), artificial airway obstruction ( = 6), decrease in blood oxygen saturation ( = 10), dyspnea ( = 5), fall pain ( = 3), elevated intracranial pressure ( = 2), and other factors ( = 3). There exhibited no significant difference in blood oxygen saturation at each time point during transport ( > 0.05). There exhibited no significant difference in SpO before transport. The comparison of 5 min and 10 min blood oxygen saturation during transit in the study group was lower compared to the control group ( < 0.05). (3) In a univariate analysis of safety risks for critically ill ICU patients, home escorts did not show significant differences in hospital transport for critically ill ICU patients ( > 0.05). There were significant differences in terms of age, patient's condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline ( < 0.05). The results of multivariate logistic regression analysis indicated that age, patient's condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline were the risk factors affecting the safe transport of critically ill patients ( < 0.05).
Age, patient's condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline are the independent risk factors that affect the safe transport of emergency or ICU critically ill patients. Therefore, in order to reduce the risk of transshipment, we must enhance the safety awareness of escorts, strengthen the management and training of escorts, promote rules and regulations, and formulate dangerous plans, so as to eliminate the occurrence of unsafe factors.
采用多变量逻辑分析探讨 ICU 危重症患者转运中安全风险的危险因素，并改进护理策略。
选取 2019 年 1 月至 2021 年 4 月我院收治的 200 例 ICU 危重症转运患者，根据转运过程中发生不安全事件的情况，将患者分为对照组（165 例无不安全事件， = 165）和研究组（35 例发生安全事件， = 35）。采用多变量逻辑分析探讨 ICU 危重症患者转运中安全风险的危险因素，并增强护理策略。
（1）受试者一般资料：200 例需要院内转运的 ICU 危重症患者中，年龄 18～85 岁，平均年龄（52.48±3.31）岁，男 89 例，女 111 例；其中胃肠道出血 35 例，呼吸衰竭 16 例，心力衰竭 23 例，心肌梗死 43 例，脑血管意外 26 例，异位妊娠 14 例，严重创伤 25 例，机械通气 18 例；研究组发生 35 例事故，B 组无事故 45 例。（2）200 例患者在转运过程中出现并发症 35 例，发生率为 17.5%，其中血压波动 6 例，人工气道阻塞 6 例，血氧饱和度下降 10 例，呼吸困难 5 例，跌倒疼痛 3 例，颅内压升高 2 例，其他因素 3 例；转运过程中各时间点血氧饱和度比较差异无统计学意义（>0.05）；转运前 SpO2 比较差异无统计学意义；研究组转运中 5 min 和 10 min 时的血氧饱和度均低于对照组，差异有统计学意义（<0.05）。（3）单因素分析显示，家庭陪护对 ICU 危重症患者院内转运安全风险无显著差异（>0.05）；年龄、患者病情、护送人员、辅助通气、转运方式、未携带药物和物品、携带管道等差异有统计学意义（<0.05）。多因素逻辑回归分析结果表明，年龄、患者病情、护送人员、辅助通气、转运方式、未携带药物和物品、携带管道是影响危重症患者安全转运的危险因素（<0.05）。
年龄、患者病情、护送人员、辅助通气、转运方式、未携带药物和物品、携带管道是影响急诊或 ICU 危重症患者安全转运的独立危险因素。因此，为降低转运风险，必须增强护送人员的安全意识，加强对护送人员的管理和培训，推动规章制度的制定，制定危险预案，消除不安全因素的发生。
