Abstract:

Objective　To investigate the effect of neurocritical program cluster management for patients with nosocomial infection and their prognosis. Methods　From January 2019 to January 2021, 116 neurocritical patients were prospectively analyzed in the Henan Provincial People's Hospital. According to the management schemes, the patients were divided into a traditional management group and a program cluster management group, with 58 cases in each group. There were 38 males and 20 females in the program cluster management group, with an age of (54.3±14.3) years. There were 33 males and 25 females in the traditional management group, with an age of (57.3±12.6) years. During the period, the infection control ability, scores of Glasgow Coma Score (GCS), Modified Rankin Scale (MRS), and National Institute of Health Stroke Scale (NIHSS), and nursing satisfaction were evaluated to compare and analyze the infection control abilities and prognosis of different management groups. t and χ² tests were applied. Results　After the two groups were treated with the traditional management and program cluster management schemes, the scores of infection control ability of the medical workers in the two groups were improved; the score in the program cluster management group was higher than that in the traditional management group [(263.3±12.4) vs. (235.5±10.3)], with a statistical difference (t=8.85, P<0.05). After the management, the scores of GSC, NIHSS, and MRS in the program cluster management group were better than those in the traditional management group [(10.12±1.66) vs. (8.13±1.52), (7.46±0.76) vs. (10.52±2.92), and (1.87±0.86) vs. (2.46±0.74)], with statistical differences (t=2.30, 7.72, and 3.96; all P<0.05). The nursing satisfaction in the program cluster management group was higher than that in the traditional management group [94.83% (55/58) vs. 82.75%(48/58)], with a statistical difference (χ²=4.25, P<0.05). Conclusion　The GSC score and nursing satisfaction of patients increase after neurocritical program cluster management, while the scores of MRS and NIHSS decrease. The results show that neurocritical program cluster management can significantly improve the infection control score of nursing care and improve their prognosis.

Key words:

Neurocritical, Cluster management, Infection control, Prognosis

摘要：

目的　探讨神经重症程序集束化管理方案对医院感染控制及预后的影响。方法　前瞻性研究分析河南省人民医院2020年1月至2021年1月116例神经重症患者，根据其管理方案可分为神经重症传统管理组和神经重症程序集束化管理组，每组各58例。观察组男性38例，女性20例，年龄（54.3±14.3）岁；对照组男性33例，女性25例，年龄（57.3±12.6）岁。期间评估感染控制能力、格拉斯哥昏迷评分（GCS）、改良Rankin量表（MRS）、美国国立卫生研究院卒中量表（NIHSS）评分和护理满意度等，以比较不同管理组的感染控制能力并分析对预后的影响，采用t检验与χ²检验。结果　两组患者分别通过神经重症传统管理和神经重症程序集束化管理方案后，对照组与观察组医护人员的感染控制能力评分均得到了提高，观察组高于对照组［（263.3±12.4）分比（235.5±10.3）分］，两组比较差异有统计学意义（t=8.85，P<0.05）。管理后，观察组与对照组患者GSC评分、NIHSS评分、MRS评分比较［（10.12±1.66）分比（8.13±1.52）分、（7.46±0.76）分比（10.52±2.92）分、（1.87±0.86）分比（2.46±0.74）分］，差异均有统计学意义（t=2.30、7.72、3.96，均P<0.05）。观察组护理满意度为94.83%（55/58），高于对照组［82.75%（48/58）］，差异有统计学意义（χ²=4.25，P<0.05）。结论　神经重症程序集束化管理后患者的GSC评分和护理满意度均较管理前升高，MRS评分和NIHSS评分均较管理前降低，表明神经重症程序集束化管理可提高护理的感染控制评分，并改善患者预后。

关键词:

神经重症, 集束化管理, 感染控制, 预后