Intensive Care Unit, Peoples' Hospital of Linxia State, Linxia, China.
Intensive Care Unit, 74713Lanzhou University Second Hospital, Lanzhou, China.
Sci Prog. 2023 Jan-Mar;106(1):368504231165663. doi: 10.1177/00368504231165663.
To determine the feasibility of a flexible visitation system in the intensive care unit (ICU).
A randomized, open-label, parallel group clinical trial was conducted. All patients admitted to the ICU of the Lanzhou University Second Hospital from April to June 2022 were enrolled. The enrolled patients were randomly divided into an experimental group and a control group according to a computer-generated random sequence table.
A total of 410 patients were admitted. According to the inclusion and exclusion criteria, 140 patients were included in the experimental group (flexible visitation group) and 140 in the control group (normal visitation group). The average number of visitation minutes per day between the experimental group and the control group was 24.7 versus 23.9 min ( > 0.05).Among the outcome indicators, delirium occurred in 8 (5.7%) patients in the intervention group and in 24 (17.1%) patients in the control group ( = 0.003). Five complaints (mainly pressure ulcers) were received, with one in the experimental group and the others in the control group. There were 28 cases of nosocomial infection in the experimental group and 29 cases in the control group; therefore, the incidence of nosocomial infection was 20% versus 20.7% ( = 0.882). A total of 280 questionnaires were collected, with a retrieval rate of 100%. The satisfaction of patients in the experimental group and the control group was 98.6% and 92.1%, respectively ( = 0.011). The flexible visiting system reduced the ICU length of stay (LOS). The ICU LOS of the experimental group was 6 versus 8 days for the control group ( = 0.041). However, the flexible visiting system did not reduce the hospital stay (17 vs. 19 days, = 0.923).
Conducting a flexible visitation system in ICUs could reduce the incidence of delirium in critically ill patients and improve the quality of nursing care; furthermore, the rate of nosocomial infections was not increased. These findings need to be further verified by a multicentre, large-scale clinical trial.
确定重症监护病房（ICU）中灵活探视制度的可行性。
采用随机、开放标签、平行组临床试验。纳入 2022 年 4 月至 6 月兰州大学第二医院 ICU 收治的所有患者。将纳入患者按照计算机生成的随机序列表分为实验组和对照组。
共纳入 410 例患者，根据纳入排除标准，实验组（灵活探视组）和对照组（常规探视组）各纳入 140 例。实验组和对照组患者每天的平均探视时间分别为 24.7 分钟和 23.9 分钟（ > 0.05）。在结局指标中，实验组发生谵妄 8 例（5.7%），对照组发生谵妄 24 例（17.1%）（ = 0.003）。共收到 5 例投诉（主要为压疮），实验组 1 例，对照组 4 例。实验组发生医院感染 28 例，对照组发生医院感染 29 例，医院感染发生率分别为 20%和 20.7%（ = 0.882）。共回收问卷 280 份，回收率 100%。实验组和对照组患者的满意度分别为 98.6%和 92.1%（ = 0.011）。灵活探视系统缩短了 ICU 入住时间。实验组 ICU 入住时间为 6 天，对照组为 8 天（ = 0.041）。但灵活探视系统并未缩短住院时间（实验组 17 天，对照组 19 天， = 0.923）。
在 ICU 实施灵活探视制度可以降低危重症患者谵妄的发生率，提高护理质量，且并未增加医院感染的发生率。这些发现需要通过多中心、大规模临床试验进一步验证。
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