The effect of hierarchical management on the early activity of ICU patients with severe pneumonia

Objective To explore the effect of hierarchical management on the early activity of severe pneumonia patients in intensive care unit (ICU). Methods A total of 100 patients with severe pneumonia in ICU admitted to Guangdong Agricultural Cultivation Central Hospital from June 2017 to May 2018 were selected. The patients were divided into observation group and control group with 50 patients in each group according to the odd and even number of inpatient beds.The control group used routine methods to judge the patients' activity ability and perform routine activities on a daily basis.The observation group divided the activity ability of ICU patients into levels A, B, C, and D according to the factors affecting the early activities of ICU patients with severe pneumonia, and developed the corresponding level of activity programs. By daily assessment of the level of patients, the corresponding activity programs were adopted for activities.The Barthel index was used to judge the activity ability of daily life, and the differences between the two groups were compared.Meanwhile, the use time of ventilator, blood oxygen saturation at the time of discharge, average length of stay in ICU, and patients' satisfaction with nursing work were compared between the two groups. Results There was no significant difference in Barthel index score between the two groups(P>0.05). There was a statistically significant difference between the Barthel index score at the time of discharge and that at the time of admission(P<0.05). The duration of ventilator use and average length of stay in ICU in the observation group were significantly shorter than those in the control group, blood oxygen saturation was significantly better than that in the control group, and nursing work satisfaction was significantly higher than that in the control group, with statistically significant differences(P<0.05). Conclusions The implementation of hierarchical management can further improve the daily living ability of ICU patients with severe pneumonia, accelerate the recovery process of patients, and improve the treatment effect and nursing satisfaction of patients. Key words: Hierarchical management; Severe pneumonia in ICU; Average length of stay in ICU; Nursing