Section Nursing Science, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
Department of Intensive Care, Ikazia Hospital, Rotterdam, the Netherlands.
HERD. 2024 Jul;17(3):68-76. doi: 10.1177/19375867241226600. Epub 2024 Feb 23.
It is proposed that patients in single-occupancy patient rooms (SPRs) carry a risk of less surveillance by nursing and medical staff and that resuscitation teams need longer to arrive in case of in-hospital cardiac arrest (IHCA). Higher incidences of IHCA and worse outcomes after cardiopulmonary resuscitation (CPR) may be the result.
Our study examines whether there is a difference in incidence and outcomes of IHCA before and after the transition from a hospital with multibedded rooms to solely SPRs.
In this prospective observational study in a Dutch university hospital, as a part of the Resuscitation Outcomes in the Netherlands study, we reviewed all cases of IHCA on general adult wards in a period of 16.5 months before to 16.5 months after the transition to SPRs.
During the study period, 102 CPR attempts were performed: 51 in the former hospital and 51 in the new hospital. Median time between last-seen-well and start basic life support did not differ significantly, nor did median time to arrival of the CPR team. Survival rates to hospital discharge were 30.0% versus 29.4% of resuscitated patients ( = 1.00), with comparable neurological outcomes: 86.7% of discharged patients in the new hospital had Cerebral Performance Category 1 (good cerebral performance) versus 46.7% in the former hospital ( = .067). When corrected for telemetry monitoring, these differences were still nonsignificant.
The transition to a 100% SPR hospital had no negative impact on incidence, survival rates, and neurological outcomes of IHCAs on general adult wards.
有人提出,单人病房(SPR)中的患者可能会受到护理和医务人员较少的监护,并且在院内心脏骤停(IHCA)发生时,复苏团队需要更长的时间才能到达。这可能会导致 IHCA 的发生率更高,心肺复苏(CPR)后的结果更差。
我们的研究旨在检查从多床位病房的医院过渡到仅 SPR 后,IHCA 的发生率和结果是否存在差异。
在荷兰一家大学医院的这项前瞻性观察性研究中,作为荷兰复苏结果研究的一部分,我们回顾了 SPR 过渡前和过渡后 16.5 个月内普通成人病房中所有 IHCA 病例。
在研究期间,共进行了 102 次 CPR 尝试:前医院 51 次,新医院 51 次。从最后一次见到患者到开始基本生命支持之间的中位时间无显著差异,CPR 团队到达的中位时间也无显著差异。存活至出院的患者比例在新医院为 30.0%,在前医院为 29.4%(=1.00),神经功能预后相当:新医院出院患者中有 86.7%的神经功能状态为 Cerebral Performance Category 1(良好的神经功能状态),而前医院为 46.7%(=0.067)。当校正遥测监测后,这些差异仍然无统计学意义。
过渡到 100%SPR 医院对普通成人病房 IHCA 的发生率、存活率和神经功能预后没有负面影响。