Abstract:

Objective To explore the effects of ICU transitional care checklist in patients undergoing cardiac surgery. Methods Totally 156 patients were recruited in a tertiary hospital in Yancheng from January 2017 to December 2018. Eighty-one patients recruited from January to December 2018 were selected as the experimental group and applied with ICU transitional care checklist combined with routine care,whereas 75 patients recruited from January to December 2017 were selected as the control group and received only routine care. The outcomes were transfer time,degree of postoperative pain at rest,incidence of postoperative complications,time of early ambulation,cost of hospitalization,length of hospitalization,and satisfaction. Medical staff were interviewed for attitude towards the checklist. Results After application of the checklist,ICU transfer time in the experimental group was significantly reduced（t=2.16,P<0.05）. There was no difference between two groups in pain degree at rest 48 hours after operation and before transferring from ICU（P>0.05）. The pain degree at rest a week after transferring from ICU,incidence of postoperative complications,and first time of early ambulation in the experimental group decreased significantly（P<0.05）. There was no significant difference in time and cost of hospitalization between two groups（P>0.05）. Patients satisfaction of the experimental group was significantly higher than that in the control group（P<0.05）. Medical staff’ satisfaction was over 96%. Medical staff were satisfied with application of the checklist. Conclusion The ICU transitional care checklist can reduce ICU transfer time,improve postoperative stress and complications in patients during cardiac perioperative period,and improve patients’ and medical staffs’ satisfaction.

Key words: Intensive Care Units, Cardiac Surgical Procedures, Checklist, Perioperative Nursing

摘要：

目的 提高心脏外科手术患者ICU过渡期护理质量。方法 设计ICU过渡期护理清单。便利选取2017年1月—2018年12月在盐城市某三级甲等医院心脏外科收治的需要行心脏手术的患者156例,其中2018年1月—12月的81例患者为试验组,2017年1月—12月的75例患者为对照组。试验组在接受常规护理基础上,采用ICU过渡期护理清单;对照组接受常规护理。比较两组转科交接时间,术后48 h、ICU转出前、ICU转出后1周3个时间点的静息状态疼痛程度,术后常见并发症发生率,术后早期下床活动时间,住院费用,住院时间及满意度,访谈医护人员对清单的看法。结果 与对照组相比,试验组转科交接时间明显缩短（t=2.16,P<0.05）,3个时间点静息状态疼痛程度明显降低（均P<0.01）;试验组术后常见并发症发生率、ICU转出后初次下床活动时间明显下降,两组差异有统计学意义（P<0.05）;两组住院时间、住院费用比较,差异无统计学意义（P>0.05）;试验组患者满意度高于对照组,差异有统计学意义（P<0.05）;护士和医生对应用该清单的满意度均>96%;访谈医护人员,对该清单的使用给予了肯定。 结论 使用ICU过渡期护理清单能够缩短心脏术后患者ICU转运时间,减少心脏围手术期患者的术后应激与并发症,提高医、护、患的满意度。

关键词: 重症监护病房, 心脏外科手术, 清单, 围手术期护理