跨专业会议对重症监护病房的影响:比较引入跨专业会议前后重症监护病房的住院时间。

Daichi Watanabe, Keiichi Uranaka, Kyoko Asazawa, Takako Akimoto, Hironori Ohnuma
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摘要

目的:本研究通过比较专业间会议引入前后的相关结果,评估其对重症监护病房(icu)的影响。患者和方法:本研究在单中心进行,纳入2017年4月至2019年3月住院的ICU患者。跨专业会议包括医生、护士、物理治疗师、营养学家和药剂师。数据是从现有的医疗记录中提取的。主要结局指标为ICU住院时间(LOS)。次要结局指标是医院LOS和ICU入院48小时内开始的任何康复和营养。比较引入跨专业会议前后的结果。调整的变量为性别、年龄、体重指数、ICU再入院、健康结果、入院时Barthel指数和疾病(根据《国际疾病及相关健康问题统计分类》第10版分类)。结果:我们纳入了2017年4月至2019年3月期间入院的1,765例ICU患者。“跨行业会议前介绍”组(前组)898例,“跨行业会议后介绍”组(后组)867例。ICU LOS(回归系数:-0.08;95%可信区间[CI]: -0.13 ~ -0.04)和医院LOS(回归系数:-2.96;95% CI: -5.20 ~ -0.72),术后组明显缩短。此外,开始营养治疗的患者比例(优势比[OR]: 1.45;95% CI: 1.14 ~ 1.84)和康复(OR: 0.77;95% CI: 0.51 ~ 1.17),入院后48小时内的死亡率明显高于对照组。结论:引入跨专业会议有效降低了ICU和医院的损失,提高了在ICU入院48小时内开始营养和康复的可能性。
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Effects of interprofessional conferences on intensive care units: comparing lengths of stay in the intensive care unit before and after the introduction of interprofessional conferences.

Objective: This study evaluated the effects of interprofessional conferences on intensive care units (ICUs) by comparing related outcomes before and after their introduction. Patients and Methods: This study was conducted at a single center and included ICU patients admitted between April 2017 and March 2019. Interprofessional conferences include physicians, nurses, physical therapists, nutritionists, and pharmacists. Data were extracted from the available medical records. The primary outcome measure was ICU length of stay (LOS). The secondary outcome measures were hospital LOS and any rehabilitation and nutrition begun within 48 hours of ICU admission. Outcomes before and after the introduction of the interprofessional conferences were compared. The adjusted variables were sex, age, body mass index, ICU readmission, health outcomes, Barthel index at admission, and disease (classified according to the International Statistical Classification of Diseases and Related Health Problems 10th edition). Results: We included 1,765 ICU patients admitted between April 2017 and March 2019. There were 898 patients in the "pre-interprofessional conference introduction" group (before group) and 867 in the "post-interprofessional conference introduction" group (after group). The ICU LOS (regression coefficient: -0.08; 95% confidence interval [CI]: -0.13 to -0.04) and hospital LOS (regression coefficient: -2.96; 95% CI: -5.20 to -0.72) were significantly shorter in the after group. Moreover, the proportion of patients who commenced nutrition (odds ratio [OR]: 1.45; 95% CI: 1.14 to 1.84) and rehabilitation (OR: 0.77; 95% CI: 0.51 to 1.17) within 48 hours of ICU admission was significantly higher in the after group. Conclusions: Introduction of interprofessional conferences effectively reduced ICU and hospital LOSs and improved likelihood of commencing nutrition and rehabilitation within 48 hours of ICU admission.

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