CNNC AND OUTCOMES IN CARDIOVASCULAR SURGICAL POPULATION

这项研究代表了一项初步努力，以记录护理独特的 对患者预后的贡献。该项目提出了初步的 现有分类法的使用和测试，“条件 护理必要性“(CNNC)及其与预后的关系 危重病人。危重病人需要高度集中治疗 以及大量的护理治疗。尽管护理是 承担最大比例的医院资源消耗， 护理对患者预后的影响几乎是未知的。这个 护理诊断的分类代表了临床判断和 护士的决策与相应的处方护理 治疗。CNNC提供有关以下方面的显著情况的信息 指导提供护理服务的病人。使用预期的 方法，在多个时间点对CNNC分类进行鉴定 医院的经验将决定疗效或差异 医院住院不同阶段实施的护理 实现患者的治疗效果。 接受冠状动脉旁路移植术的患者 被选为结果评估的目标人群。提供以下服务 对接受冠状动脉手术的患者的护理占1 占全国医疗保健支出的百分比。这项研究将考察 CNNC测评的护理需求之间的关系 分类学与生存、住院时间、功能的标准结局 健康状况和生活质量(QOL) 该分类法在预测患者预后方面的有效性将是 在一家有609张床位的社区医院对100名CABG患者进行了评估。四次 积分将代表护理需求的变化轨迹：医院 入院，手术后24小时，从外科重症监护室转院 护理单元和出院天数。FHS和QOL将分两次测量 评分：手术前和出院后4-6周。 多元回归将提供有关CNNC类别的信息 住院时间、功能健康状况和 生活质量。将使用Logistic回归来预测 生存概率。趋势分析将用于确定以下方面的趋势 CNNC的分类涵盖了敞开心扉体验的四个阶段。 这项研究测试了使用分类表示的有效性 用于确定患者状态变化的护理规定。本研究 将为医疗机构提供另一种评估方法 护理服务对患者预后的影响。

This study represents an initial effort to document nursing's unique contribution to patient outcomes. This project proposes the initial utilization and testing of an existing taxonomy, "Conditions that Necessitate Nursing Care" (CNNC) and its relationship to outcomes of critically ill patients. Critically ill patients require highly intensive and large quantities of nursing therapy. Although nursing care is responsible for the largest percentage of hospital resource consumption, the effect of nursing care on patient outcomes is virtually unknown. The taxonomy of nursing diagnoses represents the clinical judgments and decision-making of the nurse, and the corresponding prescriptive nursing treatments. The CNNC provides information regarding salient conditions in the patient that direct the provision of nursing care. Using a prospective approach, the appraisal of the CNNC taxonomy at multiple time points during the hospital experience will determine the efficacy or discrepancy of nursing care administered at different phases of hospitalization in achieving patient outcomes. Patients undergoing coronary artery bypass graft (CABG) surgery were selected as the target population for outcome assessment. The provision of care to patients undergoing coronary artery surgery accounts for one percent of the nation's health care spending. This study will examine the relationship between the need for nursing care as measured by the CNNC taxonomy and the standard outcomes of survival, length of stay, functional health status and quality of life (QOL). The taxonomy's effectiveness in predicting patient outcomes will be evaluated in 100 CABG patients at a 609 bed community hospital. Four time points will represent the change in nursing care needs trajectory: hospital admission, 24 hours after surgery, transfer from the surgical intensive care unit and day of discharge. FHS and QOL, will be measured at two time points: prior to surgery and 4-6 weeks after discharge from the hospital. Multiple regression will provide information on the CNNC categories that best predict outcomes of length of stay, functional health status and quality of life. Logistic regression will be used to predict the probability of survival. Trend analysis will be used to determine trends in the CNNC categories across the four phases of the open heart experience. This study tests the efficacy of utilization of a taxonomy representing nursing care provision for determining change in patient status. This study will provide health care institutions with an alternate method of assessing the effect of nursing services care on patient outcomes.