Research On The Establishment Of ICU Patients UEX Risk Forewarning System

Objectives:1.Establish the index system of ICU patients UEX risk forewarning system and the corresponding nursing intervention project.And then verify the reliability and validity of early warning index system.2.With ICU patients UEX risk forewarning system as the core,intervention project as guideline,information technology and hospitals’ clinical information system the basis,an automatic,intellectualized and informationalized forewarning system is ratablished,which aimed at avoidomg the nursing risk in pipelines safety and ensuring the safety of patients.Methods:1.This paper uses methods such as consult books and documentary analysis approach to drawn up the preliminary scheme initially.Then Delphi technique is chosen to revising and perfecting the intervention project.This system is established based on AHP(analytic hierarchy process)weight coefficient of each indicator and assigned corresponding scores.finally,a model of ICU patients UEX risk forewarning system is worked out.Delphi is adopted to evaluate content validity of this system.SPSS18.0 also is uses to calculate intra-class correlation coefficient,which shows the reliability among its raters.2.The model of ICU patients UEX risk forewarning system is uses to evaluate 100 ICU patients.Six index were uses to evaluate and determine critical values,including ROC curve,Youden index,sensitivity,specificity,positive predictive value and negative predictive value.With forewarning management theories as guidelines,inter-face designing principles the framework,embedding information technology into it,the establishment of system is on the basis of an overall consideration about interface layout function district,modular structure content and function,a multi-angle and multi-dimensional risk forewarning system is developed,a method that took both the subjects and structural into account is adopted throughout the whole process with the joint cooperation of researcher and computer developer,this project will be completed as planned,exploited by researcher eventually achieve all the goals.Results:1.Through two rounds of expert consultation,valid response rate stand at 100% and94.74% respectively.Kendall’W index is 0.516 and the expert authority score is0.92,finally,a model of ICU patients UEX risk forewarning system is established,including3 first-class indicators,11 second class indicators and 53 third class indicators,and a nursing intervention program is constructed,basing on 2 dimensions and a total of 23 items.Its content validity is distributed between 0.850 and 1.000,S-CVI/Ave 0.952 and reliability among raters 0.947.2.AUC of assessment result stood at 0.971 and the result is achieved through the evaluation of 100 ICU patients on the basis of ICU patients UEX risk forewarning system model.When 22 scores were chosen as optimal critical value of high risk forewarning,the system’s sensitivity is 0.875,specifity is 0.978,positive predictive value is 0.778,and negative predictive value is 0.989,in addition,its Youden index stood at 0.853,which is higher than other critical value.After calculated,its Kappa Value is 0.807(P<0.001),which showed that taking 22 scores as critical value is a good choice because it coincided quite well with practical situation.3.Prototype Of ICU patients UEX risk forewarning system consisted of six plates,including Login,Assess,decision,fore-warning guidance and pipe-fixing scheme.Nurse could login in the system through entering identification number and password,enter the duct fore-warning page and assess the amount of patients’ UEX risk according to the established risk forewarning system.The system would determine whether a patient is an UEX high-risk patient or not by analyzing the index data inputted by nurse.If one patient’s scores exceeded risk forewarning critical value,the system would chosen him as a high-risk patient of UEX and his scores would be red.A dialog box,which read as the patient is a high-risk patient of UEX,would appear on the screen at a fixed period of time.What’s more,there would be 3 red exclamatory marks,which stood for three kinds of alarm mode,appearing on the top right of the Login section.when the assessment is finished and the save button is clicked,a new page which contained the nursing intervention strategies of preventing high-risk patient of UEX.Otherwise,if the patients’ scores didn’t reach the critical value,the scores would be black,a new page which contained the nursing intervention strategies of preventing common patient of UEX.Duct fixing section contained fixed steps of 5 kinds of ducts,including trachea cannula,tracheotomy tube,nasogastric tube,uninary catheter and central ontravenous catheter.All the five pipes have high incidence of UXE.This system had guiding significance for nurses’ work in fixing pipes.Conclusion:1.Establish the index system of ICU patients UEX risk forewarning system and the corresponding nursing intervention project,which had high reliability and validity,and could be used in clinical practice.2.The critical value of ICU patients UEX risk forewarning system is determined and 22 scores were a reasonable critical value,since which has a high diagnostic value.3.An ICU patients UEX risk forewarning system based on information technology and concrete data is developed,which can accurately assess the risk of extubation and rapidly assess the risk level of patients,so as to diagnose and warn high-risk patients.