ICU联络护士在过渡期护理中工作内容的构建
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摘要
目的 :构建ICU联络护士在过渡期护理中的工作内容。方法 :基于界面理论中的交互障碍原理,剖析ICU过渡期中的护理安全问题,运用界面管理方式,结合文献分析、实地观察,构建ICU联络护士的工作内容条目池,采用德尔菲专家咨询法,对19位危重症领域医疗及护理专家进行2轮咨询。结果 :构建了3个一级条目、9个二级条目、27个三级条目的 ICU联络护士在过渡期护理中的工作内容;2轮专家咨询的有效回收率是95%及100%,最终条目重要性及可操作性变异系数范围在0.05～0.24,专家权威系数在0.81～0.87,协调程度在0.163～0.211(P<0.01)。结论 :构建的ICU联络护士在过渡期护理中的工作内容具有较高的可靠性和科学性,可以为临床上开展ICU过渡期护理提供依据。
Objective: To establish work content for the role of ICU liaison nurse in transitional care. Methods: Based on the theory of interface interaction barriers principle, we analyzed the ICU nursing safety problems in the transition period. By using the interface management way and combining the literature analysis and field observation, the work content of liaison nurse item pool was built. The Delphi expert consultation method was adopted to conduct two rounds of consultation for 19 medical and nursing experts in the field of critical illness. Results: Three first-level items, nine second-level items and twentyseven third-level items were constructed. The effective recovery rate of 2 rounds of expert consultation were 95% and 100%,the range of item importance and operability variation coefficient was between 0.05 and 0.24, the expert authority coefficient was between 0.81 and 0.87, the coordination degree was between 0.163 and 0.211(P<0.01). Conclusion: The work content of ICU liaison nurse in the transitional care has high reliability and scientificity, which can provide a basis for carrying out ICU transitional care in clinic.
Objective: To establish work content for the role of ICU liaison nurse in transitional care. Methods: Based on the theory of interface interaction barriers principle, we analyzed the ICU nursing safety problems in the transition period. By using the interface management way and combining the literature analysis and field observation, the work content of liaison nurse item pool was built. The Delphi expert consultation method was adopted to conduct two rounds of consultation for 19 medical and nursing experts in the field of critical illness. Results: Three first-level items, nine second-level items and twentyseven third-level items were constructed. The effective recovery rate of 2 rounds of expert consultation were 95% and 100%,the range of item importance and operability variation coefficient was between 0.05 and 0.24, the expert authority coefficient was between 0.81 and 0.87, the coordination degree was between 0.163 and 0.211(P<0.01). Conclusion: The work content of ICU liaison nurse in the transitional care has high reliability and scientificity, which can provide a basis for carrying out ICU transitional care in clinic.
引文
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[15]姜勤,徐玲芬,李敏,等.基于循证构建ICU获得性衰弱集束化干预策略.护理与康复,2017(5):403-406.Jiang Q,Xu LF,Li M,et al.Evidence-based cluster intervention strategy for the establishment of ICU for acquired frailty.Nursing and Rehabilitation,2017(5):403-406.
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[18]李卉妍.基于超文本的企业技术创新界面整合管理研究.上海:复旦大学出版社,2015.Li HY.Research on interface integration management of enterprise technology innovation based on hypertext.Shanghai:Fudan University Press,2015.
[19]Jonasdottir RJ,Klinke ME,Jonsdottir H.Integrative review of nurse-led follow-up after discharge from the ICU.J Clin Nurs,2016,25(1-2):20-37.
[20]肖乐乐,徐玲芬,吴巍,等.ICU联络护士在过渡期护理中的作用研究.护士进修杂志,2018(8):716-719.Xiao LL,Xu LF,Wu W,et al.Role of ICU liaison nurses in transitional care.Journal of Nurse Training,2018(8):716-719.
[2]Peters JS.Role of transitional care measures in the prevention of readmission after critical illness.Crit Care Nurse,2017,37(1):e10-e17.
[3]Ofoma UR,Yue D,Gajic O,et al.A qualitative exploration of the discharge process and factors predisposing to readmissions to the intensive care unit.BMC Health Services Research,2018,18(1):1-9.
[4]庄一渝,韦秀霞,彭剑英,等.ICU过渡期护理临床实践与研究进展.中华护理杂志,2016,51(2):211-215.Zhuang YY,Wei XX,Peng JY,et al.Clinical practice and research progress of ICU transitional care.Chinese Journal of Nursing,2016,51(2):211-215.
[5]庄一渝,叶小健,陈香萍,等.ICU重症胰腺炎患者延续护理模式的构建.中国护理管理,2017,17(9):18-21.Zhuang YY,Ye XJ,Chen XP,et al.Construction of continuous care model for ICU patients with severe pancreatitis.Chinese Nursing Management,2017,17(9):18-21.
[6]陈立萍,吴倩,韦秀霞,等.联络护士追踪护理在ICU转出患者中的应用.中华现代护理杂志,2018,24(8):927-930.Chen LP,Wu Q,Wei XX,et al.Application of liaison nurse tracking care in patients transferred from ICU.Chinese Journal of Modern Nursing,2018,24(8):927-930.
[7]张晓雪,王欣然.ICU过渡期患者安全影响因素及管理对策.中国护理管理,2018,18(4):526-529.Zhang XX,Wang XR.Influencing factors of patient safety during the ICU transition period and management countermeasures.Chinese Nursing Management,2018,18(4):526-529.
[8]蔡纯杰.界面基本理论与界面管理组织结构设计研究.福州:福州大学,2005.Cai CJ.Research on interface basic theory and interface management organization structure design.Fuzhou:Fuzhou University,2005.
[9]施雁,曾莉,田梅梅,等.应用界面理论扩大护患接触面的工作模式重建.中国医院,2013(6):11-13.Shi Y,Zeng L,Tian MM,et al.Reconstruction of working mode of applying interface theory to expand the nurse-patient interface.China Hospital,2013(6):11-13.
[10]阎蕾,朱蓓,庄若,等.基于界面管理理论的护理不良事件预控管理系统构建.护理学杂志,2018,33(8):47-50.Yan L,Zhu B,Zhuang R,et al.Establishment of nursing adverse event pre-control management system based on interface management theory.Journal of Nursing,2018,33(8):47-50.
[11]Bench S,Cornish J,Xyrichis A.Intensive care discharge summaries for general practice staff:a focus group study.Br J Gen Pract,2016,66(653):e904-e912.
[12]周松,王建宁,王婧,等.ICU转出患者家属迁移应激现状及其影响因素的研究.中华护理杂志,2017,52(8):911-915.Zhou S,Wang JN,Wang J,et al.The status quo of migration stress in families of patients transferred from ICU and its influencing factors.Chinese Journal of Nursing,2017,52(8):911-915.
[13]陈丽芳,吴岚.先天性心脏病术后患者重返ICU原因分析及护理对策.护理学报,2015(3):16-18.Chen LF,Wu L.Reason analysis and nursing countermeasures for patients returning to ICUafter congenital heart disease surgery.Journal of Nursing,2015(3):16-18.
[14]李桂芳,徐翠莲,李元贵,等.ICU患者72 h内非计划重返因素分析.重庆医学,2014(23):3102-3104.Li GF,Xu CL,Li YG,et al.Analysis of unplanned re-entry factors in ICU patients within 72 h.Chongqing Medical Journal,2014(23):3102-3104.
[15]姜勤,徐玲芬,李敏,等.基于循证构建ICU获得性衰弱集束化干预策略.护理与康复,2017(5):403-406.Jiang Q,Xu LF,Li M,et al.Evidence-based cluster intervention strategy for the establishment of ICU for acquired frailty.Nursing and Rehabilitation,2017(5):403-406.
[16]Stelfox HT,Leigh JP,Dodek PM,et al.Amulti-center prospective cohort study of patient transfers from the intensive care unit to the hospital ward.Intensive Care Med,2017,43(10):1485-1494.
[17]伍琳,孙艳杰.德尔菲法简介及在护理学中的应用现状.护理研究,2015(29):3599-3601.Wu L,Sun YJ.Introduction of Delphi method and its application in nursing.Chinese Nursing Research,2015(29):3599-3601.
[18]李卉妍.基于超文本的企业技术创新界面整合管理研究.上海:复旦大学出版社,2015.Li HY.Research on interface integration management of enterprise technology innovation based on hypertext.Shanghai:Fudan University Press,2015.
[19]Jonasdottir RJ,Klinke ME,Jonsdottir H.Integrative review of nurse-led follow-up after discharge from the ICU.J Clin Nurs,2016,25(1-2):20-37.
[20]肖乐乐,徐玲芬,吴巍,等.ICU联络护士在过渡期护理中的作用研究.护士进修杂志,2018(8):716-719.Xiao LL,Xu LF,Wu W,et al.Role of ICU liaison nurses in transitional care.Journal of Nurse Training,2018(8):716-719.