Care Bundles plus Detailed Nursing on Mortality and Nursing Satisfaction of Patients with Septic Shock in ICU

Abstract

Objective: To evaluate the effect of care bundles combined with detailed nursing on the mortality and nursing satisfaction of patients with septic shock in the intensive care unit (ICU).

Methods: Ninety patients with septic shock in the ICU admitted to our hospital from April 2019 to April 2020 were recruited and assigned to an experimental group and a control group via the random table method, with 45 cases in each group. The control group adopted conventional nursing, and the experimental group received care bundles combined with detailed nursing. The nursing effect, satisfaction, and mortality of the two groups were compared. The "Glasgow Coma Scale" (GCS) was used to evaluate the coma of the patients, the "Coma Recovery Scale" (CRS-R) was used to assess the state of consciousness of the patients, and the "Hospital Anxiety and Depression" (HAD) scale was used to evaluate the patient's emotional status before and after the intervention.

Results: The experimental group showed a significantly higher nursing efficiency and better nursing satisfaction than the control group (P < 0.05). Lower mortality was found in the experimental group in contrast to the control group (P < 0.05). The experimental group had higher GCS scores and CRS-R scores and lower HAD scores than the control group (P < 0.05).

Conclusion: Care bundles plus detailed nursing for patients with septic shock in the ICU improve the nursing effect and nursing satisfaction, reduce the mortality rate, and mitigate the clinical symptoms of patients, which shows great potential in clinical application and promotion.

Figure 1

Comparison of satisfaction between the two groups [n (%)]. Note: Figure (a) is the nursing satisfaction results of the experimental group; Figure (b) is the nursing satisfaction results of the control group; the satisfied rate of the experimental group was 71.11% (32/45), the moderately satisfied rate was 22.22% (10/45), the dissatisfied rate was 6.67% (3/45), and the overall satisfaction rate was 93.33% (42/45); the satisfied rate of the experimental group was 44.44% (20/45), the moderately satisfied rate was 28.89% (13/45), the dissatisfied rate was 26.67% (12/45), and the overall satisfaction rate was 73.33% (33/45); there was a significant difference in nursing satisfaction between the two groups of patients after intervention (X² = 6.480, P < 0.05).

Figure 2

CRS-R scores of the two groups of patients ($\overline{x}$ ± s). Note: the abscissa represents before and after the intervention, and the ordinate represents CRS-R scores and points; the CRS-R scores of the patients in the experimental group before and after intervention were (3.54 ± 1.17) points and (20.25 ± 1.37) points, respectively; the CRS-R scores of the control group before and after intervention were (3.59 ± 1.18) points and (17.14 ± 1.26) points, respectively; there is a significant difference in the CRS-R scores of the experimental group before and after the intervention (t = 62.219, ^∗P < 0.05); there is a significant difference in the CRS-R scores of patients in the control group before and after the intervention (t = 52.655, ^∗P < 0.05); there is a significant difference in CRS-R scores between the two groups of patients after the intervention (t = 11.208, ^∗P < 0.05).

Figure 3

Comparison of HAD scores between the two groups ($\overline{x}$ ± s). Note. The abscissa indicates before and after the intervention, and the ordinate indicates HAD scores and points; the HAD scores of the patients in the experimental group before and after the intervention were (35.81 ± 3.25) points and (5.36 ± 1.21) points, respectively; the HAD scores of the patients in the control group before and after the intervention were (35.88 ± 3.22) points and (13.29 ± 2.53) points, respectively; there is a significant difference in the HAD scores of the experimental group before and after the intervention (t = 58.901, ^∗P < 0.05); there is a significant difference in the HAD scores of patients in the control group before and after the intervention (t = 37.005, ^∗P < 0.05); there is a significant difference in the HAD scores of the two groups of patients after the intervention (t = 18.968, ^∗P < 0.05).