A risk scoring system to prevent self-induced accidents based on the analysis of individual sensory-perceptual actions of patients admitted to the intensive care unit.

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  • ＩＣＵ患者の個別感覚‐知覚（ＩＳＰ）行動分類に基づいた自己抜去危険度スコアの作成

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Abstract

Patients in the intensive care unit (ICU) are under unusual psychological stress and suffer from the so-called ICU syndrome. Between January 1, 1994 and March 15, 1997, we observed 698 patients for 4 days each from the time of admission to the ICU of our university hospital. We classified the patients' behavior into 23 types, and categorized them as 5 individual sensory-perceptual actions: insomnia, purposeful movement, emotional behavior, delirium and irritation. Of the 23 behaviors, “cooperative during examination”, “voluntary movement”, “getting nervous”, “saying or writing nonsense words”, “crying” and “getting angry” were highly related to self-induced accidents (for example, pulling out their own tubes). Using Quantification Formula II, we quantified 6 of the 23 behaviors as variables, and developed a risk scoring system to prevent or reduce such self-induced accidents in the ICU.<br>The use of the riskscoring system reduced the frequency of restraints and the incidence of self-induced accidents in our ICU. Objective scoring of definite factors selected from the classified actions of patients was effective in preventing self-induced accidents in our ICU.

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