摘要
目的针对急诊科综合病房住院老年患者的护理需求特点进行分析,提出可以为临床护理工作所实用的可靠对策,以期进一步提高老年患者护理服务质量。方法通过查询电子病案系统,回顾性收集2015年1月1日至2017年12月31日入住急诊综合病房的所有患者资料,采用统计描述及聚类分析、非参数秩和检验等统计推断方法对所得资料进行分析。结果共纳入患者636例,年龄83(77,87)岁,所需要护理项目4(3,5)项,明确诊断数量8(6,11)个,Charlson合并症指数4(2,5)分,住院天数15(11,21)d;诊断数量排名前5位的疾病分别为慢性阻塞性肺疾病急性加重、肺炎、肺部感染、坠积性肺炎、吸入性肺炎/慢性心功能不全急性加重;将患者接受的15项护理需求在统计分析前划分为三类:基础护理类、管路护理类、治疗相关护理类,并以此为聚类变量将636例患者分为3组,分别为高护理需求组307例、中护理需求组236例、低护理需求组93例。3组患者在死亡人数、年龄、Charlson合并症指数、明确诊断数量、住院天数方面差异均有统计学意义(P<0.05)。结论住院老年患者年龄偏高,将患者按护理需求的多少分组后,其死亡的风险逐渐增加,更容易合并更多种的疾病,住院天数延长,死亡人数也会进一步增多。临床护理人员应认识到不同类别患者的护理需求,为其提供更优质的护理服务。
Objective To understand the basic characteristics of elderly patients in the Comprehensive Ward of emergency department,put forward reliable countermeasures that can be applied to clinical nursing work,in order to provide reliable countermeasures for clinical nursing work.Methods By querying the electronic medical record system,we collected data from patients retrospectively,and used statistical inference and cluster analysis,nonparametric rank sum test and other statistical inference methods to analyze the data.Results Totally 636 patients were included,the average age of 83 years (77,87),the average required nursing project 4 (3,5),the average number of diagnosis 8 (6,11),Charlson comorbidity index (2,5) with an average of 4 points,the average hospitalization was 15 days (11,21);diagnosis the number of top five diseases for acute exacerbation of chronic obstructive pulmonary disease,pneumonia,pulmonary infection,hypostatic pneumonia,aspiration pneumonia and acute exacerbation of chronic heart failure;15 nursing needs are divided into three categories before statistical analysis,basic nursing,nursing,nursing treatment pipeline,and as cluster variables in 636 patients divided into three groups,which were high demand for nursing care group,nursing group,nursing group needs low demand. The three groups of patients were statistically significant in the number of deaths,age,Charlson complication index,the number of clear diagnosis and the days of hospitalization (P<0.05).Conclusion The average age of hospitalized elderly patients is relatively high. The risk of death is gradually increased after the patients are grouped according to the requirement of nursing. They are more likely to merge more diseases. The number of hospitalized patients is longer and the number of deaths will increase. Clinical nursing staff should recognize the nursing needs of different types of patients and provide better quality care services for them.
作者
安莹
付博晶
An Ying;Fu Bojing(Emergency Department,Affiliated Beijing Tongren Hospital of Capital Medical University,Beijing 100730, China)
出处
《中国实用护理杂志》
2019年第3期219-224,共6页
Chinese Journal of Practical Nursing
基金
首都医科大学附属北京同仁医院科研基金(2016-YJJ-HLL-009).
关键词
老年人
护理
急诊
对策
聚类分析
Aged
Nursing care
Emergency
Countermeasures
Cluster analysis
作者简介
通信作者:安莹,Email:haoanying@163.com,电话:13910431925.
