Study on the effect of comprehensive nursing intervention on reducing the incidence of unplanned extubation in ICU patients
综合护理干预对降低ICU患者非计划拔管发生率的效果研究

摘要

目的 探讨研究综合护理干预对降低ICU患者非计划拔管发生率的效果。方法 选取2023年11月至2024年2月期间收治的144例ICU患者作为研究对象，其中2023年11-12月收治的72例实施常规护理（对照组），2024年1-2月收治的72例实施综合护理干预（观察组）。针对72例实施常规护理（对照组），实施基础病情监测、健康宣教等常规护理，后期72例实施综合护理干预（观察组）开展综合护理干预，包括人员培训、流程优化、约束方式改进、舒适度提升、管道管理强化及镇静镇痛优化。研究重点观察常规护理干预和综合护理干预后患者非计划拔管发生率、舒适度变化，以及CPOT（疼痛评估）和RASS（镇静评估）评分的差异。结果 实施综合护理干预后，观察组患者非计划拔管发生率显著降低至0%，CPOT评分和RASS评分均显著低于常规护理后（p<0.05）。结论 综合护理干预措施通过多维度的护理改进，可有效降低ICU患者非计划拔管发生率，改善患者治疗效果和疼痛状况，值得在临床推广应用。

Abstract

Objective To explore and study the effect of comprehensive nursing intervention on reducing the incidence of unplanned extubation in ICU patients.
Methods A total of 144 ICU patients admitted from November 2023 to February 2024 were selected as the research subjects. Among them, 72 patients admitted from November to December 2023 received routine care (control group), and 72 patients admitted from January to February 2024 received comprehensive nursing intervention (observation group). Routine care was provided to 72 cases (control group), including basic condition monitoring and health education. Later, comprehensive nursing intervention was carried out for 72 cases (observation group), which included personnel training, process optimization, improvement of restraint methods, enhancement of comfort, strengthening of pipeline management and optimization of sedation and analgesia. The study focused on observing the incidence of unplanned extubation and changes in comfort level of patients after conventional nursing intervention and comprehensive nursing intervention, as well as the differences in CPOT (Pain Assessment) and RASS (Sedation Assessment) scores.
Results After the implementation of comprehensive nursing intervention, the incidence of unplanned extubation in the observation group was significantly reduced to 0%, and both the CPOT score and the RASS score were significantly lower than those after conventional nursing (p<0.05).
Conclusion   Comprehensive nursing intervention measures, through multi-dimensional nursing improvements, can effectively reduce the incidence of unplanned extubation in ICU patients, improve the treatment effect and pain status of patients, and are worthy of clinical promotion and application.