3种评分系统评估ICU护士个人管床数的研究
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摘要
[目的]探讨治疗干预评分系统-28(TISS-28)、改良版护理活动评分量表(NAS)、急性生理与慢性健康状况评分系统Ⅳ(APACHEⅣ)对于重症监护室(ICU)护士管床分配的适用性。[方法]采用3种评分系统于2016年12月15日—2017年6月15日对贵州省某大型三级甲等医院ICU 180d360个班次的护理工作量进行评分,评估病人330例,收集量表14 355份,根据各量表的评估分数计算每个护士管理病人数量。[结果]3种评分系统评估得分差异有统计学意义(P<0.001);改良NAS与APACHEⅣ评分呈正相关(P<0.001);改良NAS在ICU护士病人管理分配方面优于TISS-28与APACHEⅣ,即改良NAS预测分数段在40.9分～<52.9分可参考护患比为1∶2.5,52.9～<62.4分可参考1∶2.0,62.4～<68.0分可参考1∶1.5,68.0～98.4分可参考1∶1。[结论]NAS在计算护患比时更便捷,量表内容可直接反映护理工作量,改良NAS在评估ICU护士病人管理分配方面更具有适用性。
引文
[1]中华医学会.临床诊疗指南:重症医学分册[M].北京:人民卫生出版社,2009:1.
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[4]MIRANDA D R,NAP R,DE RIJK A,et al.Nursing activities score[J].Crit Care Med,2003,31(2):374-382.
[5]沙丽.用NAS对医院ICU护理工作量的调查分析[D].沈阳:中国医科大学,2007.
[6]GONCALVES L A,PADILHA K G,GURDOSO S.Nursing Activities Score(NAS):aproposal for practical application in intensive care units[J/OL].[2017-09-01].http://www.doc88.com/p-9455201697985.html.
[7]JACK E Z,ANDREW A.Acute physiology and chronic health evaluation(APACHE)Ⅳ:hospital mortality assessment for today′s critically ill patients[J].Crit Care Med,2006,5(34):1297-1310.
[8]KIEKKAS P,BROKALAKI H,MANOLIS F,et al.Patient severity as an indicator of nursing workload in the intense care unit[J].Nurs Crit Care,2007,12(1):34-41.
[9]熊楚梅,刘卫珍.APACHEⅡ评分在CCU分级监护中的应用[J].华南国防医学杂志,2009,23(3):76-77.
[10]MALSTAM J,LIND L.Therapeutic intervention scoring system(TISS)-a method for measuring workload and calculating cost in the ICU[J].Acta Aneasthesiol Scand,1992,36:758-763.
[11]王娱.APACHE-Ⅱ和APACHE-Ⅳ在心血管疾病的应用价值[D].北京:北京协和医学院,2011.
[12]熊杰,黄素芳,刘伟权.APACHE-Ⅱ评分在ICU分级护理中的应用[J].护理学杂志,2010,25(13):16-18.
[2]中华医学会重症医学分会.中国重症加强治疗病房(ICU)建设与管理指南(2006)[J].中国危重病急救医学,2006,18(7):387-388.
[3]KEENE A R,CULLEN D J.Therapeutic intervention scoring system:update1983[J].Crit Care Med,1983,11:1-3.
[4]MIRANDA D R,NAP R,DE RIJK A,et al.Nursing activities score[J].Crit Care Med,2003,31(2):374-382.
[5]沙丽.用NAS对医院ICU护理工作量的调查分析[D].沈阳:中国医科大学,2007.
[6]GONCALVES L A,PADILHA K G,GURDOSO S.Nursing Activities Score(NAS):aproposal for practical application in intensive care units[J/OL].[2017-09-01].http://www.doc88.com/p-9455201697985.html.
[7]JACK E Z,ANDREW A.Acute physiology and chronic health evaluation(APACHE)Ⅳ:hospital mortality assessment for today′s critically ill patients[J].Crit Care Med,2006,5(34):1297-1310.
[8]KIEKKAS P,BROKALAKI H,MANOLIS F,et al.Patient severity as an indicator of nursing workload in the intense care unit[J].Nurs Crit Care,2007,12(1):34-41.
[9]熊楚梅,刘卫珍.APACHEⅡ评分在CCU分级监护中的应用[J].华南国防医学杂志,2009,23(3):76-77.
[10]MALSTAM J,LIND L.Therapeutic intervention scoring system(TISS)-a method for measuring workload and calculating cost in the ICU[J].Acta Aneasthesiol Scand,1992,36:758-763.
[11]王娱.APACHE-Ⅱ和APACHE-Ⅳ在心血管疾病的应用价值[D].北京:北京协和医学院,2011.
[12]熊杰,黄素芳,刘伟权.APACHE-Ⅱ评分在ICU分级护理中的应用[J].护理学杂志,2010,25(13):16-18.