Research Of The Hierarchical Monitoring Based On APACHE ⅡScore Combined With Dynamic SOFA Score In The Application Of CRRT Nursing

Objective: A study on the intervention effect of the Hierarchical Monitoring based on APACHE Ⅱscore combined with dynamic SOFA score in the application of CRRT nursing and a better method for CRRT nursing was provided.Methods: The medical records of 40 patients admitted to the CRRT were prospective examined. The patients randomly were divided into 2 groups(n=20), the severity of APACHE Ⅱin these patients were divided into different nursing grades according to the APACHE Ⅱcriteria in the intervention groups. The SOFA score used to adjust the Nursing Grades during CRRT according to disease condition. While control group was administrated with CRRT routine nursing measures. We further investigated the effect of the Hierarchical Monitoring based on APACHE Ⅱ score combined with dynamic SOFA score in CRRT therapy by comparing their nursing defects, biochemical indicators and life of fifter. Data was statistical analysis by using software SPSS 16.0, measuring data were setted by t-test or rank sum test, and the measurement data were tested by chi-square test.Results:(1) The results showed that incidence of nursing defects and complications in the intervention group was lower than the control group’s, there was a significant difference between the intervention group and control group(c2=4.912, P=0.027).(2) The rate of incidence electrolyte disturbances was 30% in the intervention group, 55% in the control group. Both groups showed high incidence of electrolyte disturbances.(3) The patency rate of the vascular access in the intervention group was higher than the control group, and there was a significant difference(c2=10.435, P=0.001). The intervention group had a better long-time for each filter using than the control group(P<0.05). The using filter number and 24 hours of treatment costs in the intervention group was lower than the control group(P<0.05).(4) The incidence of unplanned end of CRRT in in the intervention group was lower than the control group, and there was a significant difference(c2=6.090, P=0.014).(5) The changes of the pressure parameters in the intervention group was better than the control group(P<0.05).Conclusion: The APACHE Ⅱ combined with SOFA category accuratly evaluated the CRRT patients’ contidition, its had direction significance to take corresponding nursing measure. The results of this study indicated that APACHE Ⅱ score combined with dynamic SOFA score improved therapy smoothly, extended the working life of filter, reduced the cost of treatment and led to an inhibition in adverse events. In addition, its also suppressed the occurrence of complications during CRRT therapy. Furthermore the therapeutic and nursing effects were enhanced by hierarchical monitoring during CRRT. Certain guidelines also could be given to scientific nurse-patient ratio and rational allocation of nursing resources.