Application of an integrated medical-nursing hierarchical responsibility whole-course care model in septic shock patients
Zhang Miaomiao
Gu Yanmei
Li Meng
Dong Junchen
Miao Lei
Liu Lu
Mu Rui
Abstract：Objective To investigate the application effect of an integrated medical-nursing hierarchical responsibility whole-course care model in septic shock patients,providing references for optimizing nursing interventions.Methods The ICU of the Second People's Hospital of Lianyungang implemented this model in July 2022.Forty septic shock patients receiving conven-tional care(January 2021-June 2022)were assigned to the control group,while 40 patients receiving the integrated model(July 2022-December 2023)formed the observation group.Recovery indicators,poor prognosis incidence,criticality at 3 days post-intervention,hemodynamic parameters pre-and 1-week post-intervention,and degree of satisfaction with nursing were compared.Results The observation group showed significantly shorter mechanical ventilation duration,consciousness recover-y time,duration of ICU stay,and length of hospital stay than controls(P＜0.05).Poor prognosis incidence was significantly lower in the observation group than in the control group(10.00％[4/40]vs.27.50％[11/40];x2=4.021,P=0.045).At 3 days post-intervention,lactic acid clearance rate(LCR)was significantly higher in the observation group than in the control group([26.50±4.34]％vs.[22.33±3.41]％;t=4.778,P＜0.001).Pre-intervention heart rate(HR),mean arterial pressure(MAP),and central venous pressure(CVP)showed no intergroup differences(P＞0.05);at 1 week post-interven-tion,HR decreased and MAP/CVP increased in both groups versus pre-intervention,with significantly superior outcomes in the observation group(P＜0.05).Scores on the degree of satisfaction with nursing(nurse-patient communication,ward envi-ronment,health education,and nursing skills)were significantly higher in the observation group(P＜0.05).Conclusion The integrated medical-nursing hierarchical responsibility whole-course care model promotes recovery,reduces poor prognosis risk,promotes criticality and hemodynamics,and increases the degree of satisfaction with nursing in septic shock patients.
Keywords：Hierarchical monitoring managementResponsibility system holistic nursingSeptic shockIntegrated medical-nursing careWhole-course careDegree of satisfaction
Publication Date：2025-07-20
Online Publishing Date：2025-11-19(First online date of this platform, not the publication date of the document)
Pages：6( 121-126 )