肿瘤医院住院患者发生胃管UE的临床特征分析与对策

【摘要】 目的 分析肿瘤专科医院住院患者发生胃管非计划性拔管(UE)的临床特征,探讨预防其发生的护理对策。方法 回顾性分析2008年1月至2016年12月浙江某三级甲等肿瘤专科医院发生胃管UE患者年龄、科室、时间、疾病诊断、脱管时意识状态等情况。结果 住院患者胃管UE共209例,其中≤40岁、41～59岁、≥60岁的患者分别为5例(2.39%)、63例(30.1%)、141例(67.51%)。外科、化疗科(含门诊化疗)、放疗科、妇科、ICU分别为163例(78%)、6例(2.9%)、24例(11.5%)、4例(1.9%)、12例(5.7);头颈部肿瘤、胸部肿瘤、腹部肿瘤、妇科肿瘤、其他肿瘤患者分别为24例(11.5%)、73例(34.9%)、102例(48.8%)、4例(1.9%)、6例(2.9%);脱管时间为8:00～16:59、17:00～23:59、0:00～7:59的分别为24例(11.5%)、64例(30.6%)、121例(57.9%);脱管时意识状态清醒、躁动、嗜睡瞻望、睡眠状态的分别为183例(87.6%)、7例(3.3%)、9例(4.3%)、10例(4.8%)。结论 年龄≥60岁、外科、腹部肿瘤患者、胸部肿瘤、后夜班、意识清醒状态的患者发生胃管UE的可能性较高。建议护理管理者依据脱管时间、脱管年龄特征、脱管时的意识状态等情况,加强重点时段和重点人群、特殊意识状态、特殊科室的管理,借鉴先进的管理理念、工具等预防肿瘤专科医院住院患者发生胃管UE。更多还原

【Abstract】 Objecive To analyze the clinical characteristics of unplanned gastric tube extubation on inpatients in tumor—specialized hospitals,and to study the possible prevention strategy from nursing perspective. Methods All the unplanned gastric tube extubation cases were retrospectively analyzed in a three—level. A-class tumor-specialized hospital, the category of which including the age of the patients, the department, time, diagnose result, state of consciousness during extubation, etc. Results Among the 209 cases of gastric tube extubations, 5 cases(2.39%) happened among patients aging less than 40 years old. 63 cases( 30.1%) happened among patients aging between 41-59 years old. 141 cases( 67.51%) happened among patients aging over 60 years old. Classifying by department, 163 cases( 78%) took place in the department of surgery, 6( 2.9%) in the department of chemotherapy, including chemotherapy in the outpatient sector, 24( 11.5%) in the department of radiotherapy, 4( 1.9%) in the department of gynecology, 12( 5.7%) in ICU. Classifying by the cancer type, 24( 11.5%) in head and neck tumor, 73( 34.9%) in chest tumor, 102( 48.8%)in abdominal tumor, 4( 1.9%) in gynecological tumor, 6( 2.9%) in other kinds of tumor. Classifying by time, the numbers of cases and rates are,24( 11.5%) happened between 8:00～16 : 59, 64( 30.6%) between 17 : 00～23 : 59, 121( 57.9%) between 0 : 00～7 : 59. Finally, classifying by the state of patients during extubation, in 183( 87.6%) cases the patient was conscious, in 7 cases( 3.3%) the patient was agitated, in 9 cases( 4.3%)the patient was in drowsiness, in 10 cases( 4.8%) the patient was asleep. Conclusion There is a higher possibility that unplanned gastric tube extubation will occur among patients more than 60 years old, or for patients with abdominal tumor, chest tumor, or for patients in conscious state. There is a higher occurrence in the department of surgery and during the late night shift. Thus, this paper suggests that the management for the mentioned time,patient group and department be enhanced. according to the time of extubarion. age feature and state of consciousness during extubation. Based on the more advanced theory and instrument, the occurrence of unplanned gastric tube extubation for patients in specialized tumor hospital should be avoided.更多还原