广泛慢性危重症患者出院管理临床实践专家共识(2024版)OA北大核心CSTPCD

Adequate discharge management can effectively reduce the probability of relapse and readmission of patients with extensive chronic critical illness(ECCI).In order to guide medical staff to improve the discharge management ability of EC-CI patients and improve the discharge quality of ECCI patients,this consensus proposes that all the disease states with the five characteristics of critical illness,diversity of manifestations,difficulty in treatment,long-term course of disease,and recurrence of disease are collectively referred to as ECCI,in which discharge should be put on the agenda and discharge management should be arranged when the patients'condition is relatively stable.The evaluation of the following items should be performed before discharge,including vital signs,cardiopulmonary function,state of consciousness,necessity and risk of catheter retention,swallowing function,gastrointestinal function and feeding capacity,mobility,pain status,patient's mental state and compliance,and family members'willingness and ability to care for the patients.It is recommended to use the tabular method to select the medical supplies and educational training programs that ECCI patients may need to prepare for discharge and to implement them.The ECCI patients and the primary family caregivers of them should be trained on rele-vant medical knowledge and skills and their knowledge and ability should be evaluated prior to discharge.It is necessary to ensure the safety of discharge transport and follow-up of ECCI patients after discharge.