重症监护病房的设置方面

ASPECTS OF THE INTENSIVE CARE UNIT SETTING 重症监护病房的设置方面

Patients with critical illness in the intensive care unit (ICU) usually require advanced life support with mechanical ventilation, inotropic medications, or dialysis. 在重症监护病房（ICU）与重大疾病的患者，通常需要机械通气，正性肌力药物，或透析的高级生命支持。Morbidity associated with critical illness includes complications of both acute and chronic diseases, nosocomial and iatrogenic consequences, and impaired quality of life among survivors. 与重大疾病相关的发病率，包括急性和慢性疾病，院内感染和医源性的后果，以及幸存者的生活质量受损并发症。Critically ill patients are at a higher risk of death than any other hospital population. 危重病人在一个较高的死亡风险比其他任何医院人口。Accordingly, the goals of critical care are to reduce the morbidity and mortality, to maintain organ function, and to restore health. 因此，危重病的目标是降低发病率和死亡率，以维持器官的功能，并恢复健康。Unlike many other specialties, critical care medicine is not limited to a particular population, disease, diagnosis, or organ system. 不像许多其他的特色，危重病急救医学并不局限于某一特定人群，疾病诊断，或器官系统。

The Intensivist-Led Multidisciplinary Team Intensivist为首的多学科小组

Staffing of ICUs with critical care physicians, often referred to as intensivists, who provide mandatory consultation or are responsible for all care is associated with a significantly lower ICU and hospital mortality and a shorter ICU and hospital length of stay. 重症监护医生，危重，提供了强制性的咨询，或负责所有的护理是显着降低重症监护病房和住院死亡率和较短的重症监护病房和住院时间长，通常被称为加护病房的人员编制。These findings may be due to the on-site availability of trained physicians dedicated to appropriate triage, prevention, diagnosis, monitoring, treatment, and palliation of critically ill patients. 这些研究结果可能是由于专门适当分流的预防，诊断，监测，治疗和姑息治疗的危重病人受过训练的医生对网站的可用性。

In addition, daily rounds by an ICU physician who leads a multidisciplinary team appears to improve outcomes, probably because leadership, communication, and organizational culture can streamline the process of critical care. 此外，由ICU医生每天查房谁领导的多学科团队出现改善的结果，可能是因为领导，沟通，组织文化可以简化关键护理的过程中。These favorable findings may be due to the intensivist-coordinated teamwork of nurses, respiratory therapists, dietitians, and pastoral care workers. 这些有利的结果可能是由于护士intensivist协调的团队精神，呼吸治疗师，营养师，和牧灵工作者。

Applying Evidence to Prevent Complications of Critical Illness运用证据，以防止并发症，危重病

Considerable randomized trial evidence about effective preventive and therapeutic interventions has emerged in the ICU during the last decade. 在过去十年中，约相当有效的预防和治疗干预措施的随机试验证据已经出现在ICU。However, barriers to the application of this evidence reflect the ICU setting itself, which is characterized by

fast-paced decision making by many clinicians, sometimes leading to a lack of responsibility and decision-making authority as well as errors of omission. 然而，应用这方面的证据的障碍，反映ICU的设置本身，这是由快节奏的决策许多医生特点，有时会导致缺乏责任和决策权以及遗漏的错误。Effective strategies to encourage implementation of