Effect of clustering nursing on treating severe acute stroke patients underwent risk management
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摘要:目的 探讨对急诊重症脑卒中患者实施集束化护理的临床效果。方法 选取2017年8月—2019年2月本院急诊所收治重症脑卒中患者120例，按照就诊时间将其分为观察组(2018年6月—2019年2月)和对照组(2017年8月—2018年5月)，分别接受集束化护理和常规护理，对2组患者短期预后、高危风险事件及护理质量进行评估分析。结果 观察组患者短期预后不良事件发生率显著低于对照组(P < 0.05); 观察组患者高风险事件发生率显著低于对照组(P < 0.05); 实施集束化护理后，观察组护理安全态度评估中压力认知、满意度、工作条件、管理认知、安全氛围、团队协作6个维度评分均显著高于实施前，差异有统计学意义(P < 0.05)。结论 对急诊重症脑卒中患者实施集束化护理，可有效预防风险事件并减少不良刺激的发生率，对于增强护理人员的安全态度，提高科室护理质量具有十分积极的作用。Abstract:Objective To explore the clinical effect of clustering nursing for patients with severe acute stroke.Methods A total of 120 severe acute stroke patients admitted to the emergency department in our hospital from August 2017 to February 2019 were selected and divided into observation group (June 2018 to February 2019)and control group (August 2017 to May 2018)according to the hospitalization time. The two groups were given clustering nursing and routine nursing, respectively. Short-term prognosis, high risk events and the nursing quality of the two groups were evaluated and analyzed.Results The incidences of short-term adverse events of prognosis, and high risk events in the observation group were both significantly lower than the control group(P < 0.05).After clustering nursing, the observation group had higher scores in six dimensions including stress cognition, satisfaction, working conditions, management cognition, safety climate and teamwork compared to nursing before(P < 0.05).Conclusion The application of clustering nursing in the severe acute stroke patients can effectively prevent risk events and reduce the incidence of adverse stimulation, and also has a positive effect on improving the safety attitude of nurse and nursing quality of the department.
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表 1 观察组集束化护理实施前后护理安全态度评估结果
时点 n 压力认知 满意度 工作条件 管理认知 安全氛围 团队协作 实施前 60 2.11±0.75 2.74±0.81 2.88±0.93 2.97±0.65 2.65±0.67 2.35±0.61 实施后 60 2.54±0.58* 3.62±0.43* 3.72±0.61* 3.64±0.55* 3.75±0.39* 3.54±0.56* 与实施前比较, *P < 0.05。 
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[1] Hayward K S, Lohse K R, Bernhardt J, et al. Characterising Arm Recovery in People with Severe Stroke (CARPSS): protocol for a 12-month observational study of clinical, neuroimaging and neurophysiological biomarkers[J]. BMJ Open, 2018, 8(11): e26435. http://bmjopen.bmj.com/content/8/11/e026435.full
[2] 万金华. 呼吸道灌洗法在重症脑卒中患者吸痰护理中的应用及效果[J]. 当代护士: 中旬刊, 2015, 22(9): 17-18. https://www.cnki.com.cn/Article/CJFDTOTAL-DDHS201509007.htm [3] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国重症脑血管病管理共识2015[J]. 中华神经科杂志, 2016, 49(3): 192-202. doi: 10.3760/cma.j.issn.1006-7876.2016.03.004 [4] 刘欣敏, 高岚. 预防重症脑卒中患者误吸的集束化干预护理培训效果分析[J]. 中国实用护理杂志, 2016, 32(11): 826-830. doi: 10.3760/cma.j.issn.1672-7088.2016.11.007 [5] Geurts M, de Kort F A, de Kort P L, et al. Treatment restrictions in patients with severe stroke are associated with an increased risk of death[J]. Eur Stroke J, 2017, 2(3): 244-249. doi: 10.1177/2396987317704546
[6] Yao J, Dewald J P A. The increase in overlap of cortical activity preceding static Elbow/Shoulder motor tasks is associated with limb synergies in severe stroke[J]. Neurorehabil Neural Repair, 2018, 32(6/7): 624-634. http://www.ncbi.nlm.nih.gov/pubmed/29890871
[7] 郭霞. 中文修订版安全态度调查问卷的初步研究[D]. 太原: 山西医科大学, 2009. [8] Mcglinchey M P, James J, Mckevitt C, et al. The effect of rehabilitation interventions on physical function and immobility-related complications in severe stroke-protocol for a systematic review[J]. Syst Rev, 2018, 7(1): 191-203. doi: 10.1186/s13643-018-0870-y
[9] 张瑞雪, 涂双燕, 陈德智, 等. 重症脑卒中患者护理质量敏感指标的研究进展[J]. 中华护理杂志, 2018, 53(8): 1005-1009. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL201808031.htm [10] Yuan F, Yang F, Zhang W, et al. Optimizing early enteral nutrition in severe stroke (OPENS): protocol for a multicentre randomized controlled trial[J]. BMC Neurol, 2019, 19(1): 24-29. doi: 10.1186/s12883-019-1253-2/fulltext.html
[11] Langhammer B, Sunnerhagen K S, Stanghelle J K, et al. Life satisfaction in persons with severe stroke-A longitudinal report from the Sunnaas International Network (SIN) stroke study[J]. Eur Stroke J, , 2017, 2(2): 154-162. http://www.researchgate.net/publication/314026649_Life_satisfaction_in_persons_with_severe_stroke_-_A_longitudinal_report_from_the_Sunnaas_International_Network_SIN_stroke_study
[12] Balasubramanian S, Garcia-Cossio E, Birbaumer N, et al. Is EMG a Viable Alternative to BCI for Detecting Movement Intention in Severe Stroke[J]. IEEE Trans Biomed Eng, 2018, 65(12): 2790-2797. http://ieeexplore.ieee.org/document/8320831
[13] Zhu S, Gao X, Huang K, et al. Glibenclamide Enhances the Therapeutic Benefits of Early Hypothermia after Severe Stroke in Rats[J]. Aging Dis, 2018, 9(4): 685-695. http://www.ncbi.nlm.nih.gov/pubmed/%2030090656
[14] Hoonhorst M, Nijland R, van den Berg P, et al. Does Transcranial Magnetic Stimulation Have an Added Value to Clinical Assessment in Predicting Upper-Limb Function Very Early After Severe Stroke[J]. Neurorehabil Neural Repair, 2018, 32(8): 682-690. http://europepmc.org/abstract/MED/29972088
[15] 杨珊珊, 龚蕉椒. 重症脑卒中溶栓术后感染鲍曼不动杆菌病人的预防及护理[J]. 全科护理. 2017, 15(22): 2729-2730. https://www.cnki.com.cn/Article/CJFDTOTAL-JTHS201722019.htm [16] Mi H, Li S, Li H, et al. The effects of infection on severe stroke patients in the neurological intensive care unit in China[J]. Int J Neurosci, 2018, 128(8): 715-720. doi: 10.1080/00207454.2017.1412966
[17] 吕芬, 吴荣钰, 李文巧. 集束化护理对脑卒中后吞咽障碍患者营养状况及再入院率的影响研究[J]. 护理与康复, 2017, 16(8): 852-855. https://www.cnki.com.cn/Article/CJFDTOTAL-HLKF201708012.htm [18] 丁敏. 集束化护理对脑卒中吞咽功能障碍患者康复效果及生活质量的影响[J]. 国际护理学杂志, 2018, 37(8): 1088-1091. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX201508029.htm -
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