專責重症專科醫師對外科加護病房患者的照護品質提升之探討

The Effect of Intensivists Staffing in Surgical Intensive Care Units

廖憲華(Hsien-Hua Liao) ； 吳志隆(Chih-Lung Wu) ； 周明智(Ming-Chih Chou) ； 陳幹珍(Kang-Ding Tung) ； 邱韋欽(Wei-Chin Chiou)

《重症醫學雜誌》 10卷1期 (2009/03) Pp. 2-7

https://doi.org/10.30035/TCCM.200903.0001

摘要

Objectives: This study collected data from a surgical intensive care unit to determine whether the presence of an on-site, organized, intensivist critical care service improved care and decreased mortality.
Methods: It was an observational, descriptive study (with historical control) that collected data from surgical intensive care unit adult patients (aged≧18) at a university hospital in central Taiwan from July 2002 to June 2004. The duration of this study was two years (one year before and one year after the implementation of critical care intensivist staffing in July 2003). The major index were patient APACHEII Score≧25 (within 24 hours of ICU admission), survival rate, the length of ICU stay, and whether intensivist care had been received; the care efficacy was evaluated and tested by chi-square test and independent sample t-test.
Results: The total samples were 199 patients; the numbers of patients before and after the intensivist care implementation were 71 and 128, respectively. From the aspect of care efficacy, the patient survival rate was 54.7% with intensivist care; whereas, the survival rate was 39.4% for patients without intensivist care. A significant difference was found by chi-square test (p＜0.05). On the aspect of length of ICU stay, the average was 11.2±9.0 days for the surviving patients with intensivist care; the average was 7.3±5.5 days for the surviving patients without intensivist care. A significant difference was found by independent sample t-test (p＜0.05).
Conclusions: The better survival rate was found for patients with intensivist care in this study; therefore, it proved that the quality of care can be increased practically with intensivist care in surgical intensive care units.

關鍵字

專責重症專科醫師 ； 加護病房 ； 存活率

並列摘要

Objectives: This study collected data from a surgical intensive care unit to determine whether the presence of an on-site, organized, intensivist critical care service improved care and decreased mortality.
Methods: It was an observational, descriptive study (with historical control) that collected data from surgical intensive care unit adult patients (aged≧18) at a university hospital in central Taiwan from July 2002 to June 2004. The duration of this study was two years (one year before and one year after the implementation of critical care intensivist staffing in July 2003). The major index were patient APACHEII Score≧25 (within 24 hours of ICU admission), survival rate, the length of ICU stay, and whether intensivist care had been received; the care efficacy was evaluated and tested by chi-square test and independent sample t-test.
Results: The total samples were 199 patients; the numbers of patients before and after the intensivist care implementation were 71 and 128, respectively. From the aspect of care efficacy, the patient survival rate was 54.7% with intensivist care; whereas, the survival rate was 39.4% for patients without intensivist care. A significant difference was found by chi-square test (p＜0.05). On the aspect of length of ICU stay, the average was 11.2±9.0 days for the surviving patients with intensivist care; the average was 7.3±5.5 days for the surviving patients without intensivist care. A significant difference was found by independent sample t-test (p＜0.05).
Conclusions: The better survival rate was found for patients with intensivist care in this study; therefore, it proved that the quality of care can be increased practically with intensivist care in surgical intensive care units.

並列關鍵字

Intensive Care Units ICUs ； Intensivists ； Survival rate