重症儿童早期康复:两中心实施研究
Karen Choong1,2, Douglas D Fraser3, Ahmed Al-Farsi1
1Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
概括
在儿科重症监护室 (PICU) 实施早期康复套餐,改善了护理流程,减少了镇静剂的使用,但没有增加患者的危害. 在这项研究中,临床结果没有显著影响.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 实施科学 实施科学
- 康复疗法 康复疗法
背景情况:
- 儿科重症监护室 (PICU) 经常涉及长时间的镇静和不运动.
- 早期康复干预对于改善重症儿童的治疗结果至关重要.
- 实施标准化护理包带来了实施挑战.
研究的目的:
- 在加拿大两个PICU中实施和评估早期康复套餐.
- 评估包对护理流程,安全和临床结果的影响.
- 识别促进者和阻碍捆绑实施的障碍.
主要方法:
- 在加拿大的两个PICU中进行了一项实施研究.
- 康复包包括止痛先镇静,妄想监测/预防和早期动员.
- 在26个月内收集了有关实施,合规性,安全性和临床结果的数据.
主要成果:
- 在六个月内实现了捆绑合规;动员目标设定得到改善.
- 镇静剂 (二甲,阿片类药物,德克斯梅德托米丁) 的使用在一个地点显著下降.
- 没有观察到对患者舒适性,安全性或护理工作负载的不良影响.
- 没有对妄,无呼吸器日,停留时间或死亡率产生显著影响.
结论:
- 早期康复包可以增强PICU护理过程,并安全地减少镇静剂暴露.
- 在这项实施研究中,捆绑药物并没有显著改善短期临床结果.
- 需要进一步的研究来证实PICU康复套餐的有效性.
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