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首页> 外文学位 >Impact on Health Outcomes of Boarding Postoperative Critically Ill Stable Older Patients.
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Impact on Health Outcomes of Boarding Postoperative Critically Ill Stable Older Patients.

机译：登上危重病情稳定的老年患者对健康结局的影响。

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Background: Optimizing patient flow can be one of the greatest challenges for nurse leaders in tertiary referral hospitals. It is essential to implement best processes to enhance the patient flow, to maximize bed availability and avoid boarding.;Purpose: To evaluate the impact of PACU boarding on the health outcomes of critically ill stable older postoperative patients waiting for an ICU bed.;Methods: This was a case-control study that used secondary data from the Project IMPACT Database populated between 2002 and 2010 in a tertiary referral safety net institution. A total of 145 patients age 65 to 85 years of age who were boarded in the PACU (> 6 hours) were matched 1:1 on admission year and gender to patients who were recovered (< 6 hours [control group]) in the PACU (total sample 290 patients, 145 pairs).;Results: The average age of patients was 73 years, 53% were male, and were predominately White (71%). Hospital LOS (20.26 days + 37.2 days) was longer for boarded PACU patients than the control group (14.72 days + 13.55 days) which was clinically relevant (5.5 days) but not statistically significant (p = 0.054). As hypothesized, there was no statistically significant difference between those who boarded in the PACU or recovered in the PACU in terms of postoperative LOS, decline in functional status and hospital mortality. However, postoperative LOS was also clinically relevant with PACU boarders spending on average 4.5 days longer in the hospital than the control group (17.10 + 34.64 versus 12.60 + 12.47 respectively). When controlling for age and race with a postoperative LOS > 9 days, PACU boarders were 1.7 times (95% CI: 1.054-2.767, p = 0.03) the odds of having a longer postoperative LOS than the control group.;Conclusions: Further research is needed to identify contributing factors associated with prolonged postoperative LOS in those critically ill older stable surgical patients who board in the PACU after surgery. Nurse leaders responsible for patient flow may also need to consider the potential financial implications of boarding along with quality of care metrics. Key Words: PACU boarding, health outcomes, patient flow.
机译：背景：优化患者流量可能是三级转诊医院护士领导面临的最大挑战之一。实施最佳流程以增强患者流量，最大化床位可用性并避免登机是至关重要的；目的：评估PACU登机对重症病情稳定，等待ICU病床的老年术后患者健康结果的影响；方法：这是一项病例对照研究，使用了2002年至2010年之间在三级转诊安全网机构中填充的Project IMPACT数据库中的辅助数据。共有145名65至85岁年龄在PACU登机（> 6小时）的患者在入院时和性别方面与在PACU中康复（<6小时[对照组]）的患者1：1匹配（总共290例患者，共145对患者）。结果：患者的平均年龄为73岁，其中53％为男性，主要是白人（71％）。住院PACU患者的住院时间（20.26天+ 37.2天）比对照组（14.72天+ 13.55天）长，这与临床相关（5.5天）但无统计学意义（p = 0.054）。如所假设的，就术后LOS，功能状态下降和医院死亡率而言，在PACU登机或在PACU中康复的患者之间没有统计学上的显着差异。但是，术后LOS在临床上也与PACU寄宿生在医院的平均花费相比，对照组要长4.5天（分别为17.10 + 34.64和12.60 + 12.47）。在术后LOS> 9天时控制年龄和种族时，PACU寄宿生的术后LOS比对照组长的几率是正常人的1.7倍（95％CI：1.054-2.767，p = 0.03）。结论：进一步研究对于那些在手术后登上PACU的危重病，稳定的老年手术患者，需要确定与术后LOS延长相关的因素。负责患者流量的护士领导者可能还需要考虑登机的潜在财务影响以及护理质量指标。关键字：PACU寄宿，健康结果，病人流量。

著录项

  • 作者

    Charsha, Dianne Susan.;

  • 作者单位

    Drexel University.;

  • 授予单位 Drexel University.;
  • 学科 Health care management.;Nursing.;Health sciences.
  • 学位 D.N.P.
  • 年度 2016
  • 页码 108 p.
  • 总页数 108
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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