Efforts to reduce the length of stay in a low-intensity ICU: Changes in the ICU brought about by collaboration between Certified Nurse Specialists as head nurses and intensivists
Efforts to reduce the length of stay in a low-intensity ICU: Changes in the ICU brought about by collaboration between Certified Nurse Specialists as head nurses and intensivists
复制标题
DOI：
10.1371/journal.pone.0234879
复制
发表时间：
2020-06-15
期刊：
影响因子：
3.7
通讯作者：
Kashiwagi, Masanori
中科院分区：
文献类型：
--
作者：
Fukuda, Tomohide;Sakurai, Hironori;Kashiwagi, Masanori
认证护士专家（CNS）是高级实践护士，通常在管理中发挥作用。本研究旨在探讨重症监护室（ICU）护士长与重症监护医师之间的合作是否会改变ICU患者的住院时间。遵循单中心回顾性队列研究设计。进行多变量回归分析，以确定患者在ICU住院时间两年之前和之后CNS作为ICU护士长和重症监护医师开始合作是否有差异。从该机构的电子病历中收集患者的诊断、年龄、性别、计划/急诊入院、手术史、ICU住院时间、呼吸机使用情况和ICU治疗详情。在研究期间（2015年4月至2019年3月），有3，135名患者入住ICU，其中1，471名在合作前组，1，664名在合作后组。CNS作为护士长和重症监护医师之间的合作与ICU停留时间的缩短显著相关（系数-0.03 [95%CI，-0.05-0.01]，p<0.001，t统计-3.29）。我们的主要发现说明，在低强度ICU，CNSs作为护士长和重症监护医生之间的合作可能会减少患者的ICU停留时间。
Certified Nurse Specialists (CNS) are advanced practice nurses that often play a role in management. This study aims to investigate whether cooperation between CNSs in the position of Intensive Care Unit (ICU) head nurse and intensivists change the length of stay for ICU patients. A single centered retrospective cohort study design was followed. A multivariable regression analysis was performed to determine whether there is a difference in patients' length of ICU stay for two years before and after CNS as ICU head nurse and an intensivist started collaborating. The patients' diagnosis, age, gender, scheduled/emergency admission, surgical history, length of ICU stay, usage of ventilator, and details of ICU treatment were collected from the institution's electronic medical records. During the study period (April 2015 to March 2019), 3,135 patients were admitted to ICU, with 1,471 in the before collaboration group and 1,664 in the after-collaboration group. Collaboration between the CNS as head nurse and intensivists was significantly associated with shorter length of ICU stay (coefficient -0.03 [95% CI, -0.05-0.01],p< 0.001,t-statistic -3.29). Our main finding illustrates that in low-intensity ICUs, collaboration between CNSs as head nurses and intensivists may reduce patients' length of ICU stay.