Application and prognostic impact of nursing humanistic care combined with infection control in ICU critically ill patients
护理人文关怀联合院感防控在ICU重症患者中的应用及预后影响

摘要

目的 探讨护理人文关怀联合院感防控干预对ICU75-90岁重症患者（尤其多重耐药患者）的应用效果及对预后影响，重点观察压力性损伤发生率变化。方法 选取2023年10月至2025年10月我院ICU该年龄段60例重症患者（多重耐药28例），随机分对照组和实验组各30例（两组多重耐药各14例）。对照组行ICU常规护理，实验组在常规护理基础上实施护理人文关怀联合院感防控专项干预，并强化压力性损伤针对性护理。用SPSS 26.0分析比较两组院感发生率、压力性损伤发生率、护理满意度、ICU住院时间、机械通气时间及28 d生存率。结果 实验组院感发生率6.67%显著低于对照组的26.67%（χ² = 4.320，P = 0.038）；压力性损伤发生率3.33%（多重耐药患者发生率7.14%）显著低于对照组的20.00%（多重耐药患者发生率42.86%）（χ² = 4.043，P = 0.044）；护理满意度96.67%显著高于对照组的76.67%（χ² = 5.192，P = 0.023）；ICU住院和机械通气时间分别为（8.24±2.15）d、（5.31±1.87）d，均显著短于对照组（t = 4.861、4.523，P均<0.001）；28 d生存率90.00%高于对照组的73.33%（χ² = 2.786，P = 0.095，接近显著水平）。结论 该联合干预可降低院感和压力性损伤发生率（尤其改善多重耐药患者压力性损伤高发问题），提高护理满意度，缩短住院和通气时间，改善预后，有临床应用价值。

Abstract

Objective To investigate the application effect and prognostic impact of nursing humanistic care combined with hospital infection prevention and control intervention on 75 - 90 - year - old critically ill patients in the ICU (especially multidrug - resistant patients), focusing on pressure injury incidence changes.
Methods From Oct 2023 to Oct 2025, 60 critically ill patients of this age group in our hospital’s ICU (28 were multidrug - resistant) were randomly divided into a control and an experimental group, 30 cases each (14 multidrug - resistant in each). The control group received routine ICU nursing, while the experimental group got nursing humanistic care combined with specialized hospital infection prevention and control intervention on routine care basis and strengthened targeted pressure injury nursing. Hospital infection incidence, pressure injury incidence, nursing satisfaction, ICU stay, mechanical ventilation time, and 28 - day survival rate were compared between the two groups using SPSS 26.0.
Results The experimental group had a 6.67% hospital infection incidence, significantly lower than the control group’s 26.67% (χ² = 4.320, P = 0.038). The experimental group’s pressure injury incidence was 3.33% (7.14% in multidrug - resistant patients), significantly lower than the control group’s 20.00% (42.86% in multidrug - resistant patients) (χ² = 4.043, P = 0.044). Nursing satisfaction was 96.67% in the experimental group, significantly higher than the control group’s 76.67% (χ² = 5.192, P = 0.023). The experimental group’s ICU stay and mechanical ventilation time were (8.24±2.15) days and (5.31±1.87) days, significantly shorter than the control group’s (t = 4.861, 4.523, P < 0.001). The 28 - day survival rate was 90.00% in the experimental group, higher than the control group’s 73.33% (χ² = 2.786, P = 0.095, approaching significance).
Conclusion   This combined intervention can reduce hospital infection and pressure injury incidence (especially for multidrug - resistant patients), improve nursing satisfaction, shorten ICU stay and mechanical ventilation time, and improve prognosis, showing clinical application value.