识别早期阿片类药物诱导的呼吸系统抑郁症和快速反应团队激活
Leah Durden1, Brandi N Wilford2
1Charge Nurse, Cardiovascular and Thoracic Care Unit, John Muir Medical Center, Concord, California.
概括
在胸部手术患者中实施PRODIGY工具来预测阿片类药物诱导的呼吸抑制 (OIRD) 并没有显著增加快速响应小组 (RRT) 的激活. 然而,观察到RRT激活的临床上略有增加.
科学领域:
- 医疗安全 医疗安全
- 改善临床质量 改善临床质量
- 呼吸系统护理 呼吸系统护理
背景情况:
- 阿片类药物会造成呼吸系统抑郁的风险,可能会伤害患者.
- 在识别和监测患有阿片类药物诱导呼吸系统抑郁症 (OIRD) 风险的术后胸部患者方面存在差距.
- 寻求基于证据的解决方案来解决这一监测缺口.
研究的目的:
- 评估实施预测阿片类药物诱导的呼吸系统抑郁症的风险预测工具 (PRODIGY) 对快速反应小组 (RRT) 激活的影响.
- 为了评估翻译的有效性,Khanna等. (2020) 心血管和胸部护理单位 (CVTCU) 的研究.
主要方法:
- 一个为期四周的定量准实验性质量改进项目.
- 研究了两组术后胸部患者 (共n=29).
- 对比组 (n=12) 用脉冲氧计进行OIRD识别. 实施小组 (n=17) 使用了PRODIGY工具,其中包括脉冲氧量测量和隐形图.
主要成果:
- 两组之间没有发现RRT激活的统计学上显著差异 (χ2(1,n=29) =0.73,p=0.393).
- 在实施组中观察到RRT激活的临床显著增加5.9%.
- 该PRODIGY工具确定了患有OIRD风险的患者.
结论:
- 实施PRODIGY风险预测工具和图监测可能会影响术后胸部患者的RRT激活.
- 需要进一步的研究来证实临床意义和优化OIRD监测协议.
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