Effect of ICU specialist care quality control team management program in continuous renal replacement therapy: A retrospective comparative study

ICU专科护理质量控制团队管理方案对连续性肾脏替代治疗的影响:一项回顾性比较研究

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Abstract

This study aims to evaluate the effectiveness of the intensive care unit (ICU) specialist care quality control team management of patients treated with continuous renal replacement therapy (CRRT). A retrospective comparative study design was used to compare 2 groups of critically ill CRRT patients in the ICU. Subjects were 519 critically ill CRRT patients admitted to the ICU from January 2018 to December 2021. The control group (n = 265) received routine bedside care management of CRRT, and the experimental group (n = 254) received management by the CRRT specialist quality control group. Outcomes compared included unplanned down rate, unplanned down time, continuous treatment > 24 hours up to standard rate, 72 hours up to standard scheduled down rate, average daily hemodialysis cost, average use time of a single filter, unplanned extubation rate, incidence of catheter-associated bloodstream infection, nursing satisfaction, blood biochemical indexes, and coagulation indexes. The experimental group had a lower unplanned down rate(28.8% vs 42.6%), increased average unplanned down time (20.91 ± 11.21 vs 15.71 ± 7.33), higher continuous treatment > 24 hours up to standard rate (69.0% vs 55.5%), increased 72 hours up to standard scheduled down rate (16.7% vs 8.6%), decreased average daily hemodialysis cost (2947.3 ± 231.22 vs 3508.3 ± 423.22), prolonged average use time of a single filter (39.8 ± 9.47 vs 25.84 ± 7.62), lower unplanned extubation rate (1.9% vs 12.8%), and lower incidence of catheter-related bloodstream infection (0.7% vs 6.8%) compared to the control group (P < .05). The experimental group showed higher nursing satisfaction than the control group (92.9% vs 75.1%, P < .05). Blood potassium, sodium, blood urea nitrogen, and serum creatinine levels were significantly lower in the experimental group, with improved coagulation index values compared to controls (P < .05). ICU nursing quality control team management plan improve the quality of medical care, ensure patients to achieve good therapeutic effect of the goal, worthy of clinical application.

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