使用3D打印屏障模板在NICU中减少与呼吸器设备相关的压力损伤
Lydia Goodyear1, Rakesh Rao2, Julia Huck1
1St Louis Children's Hospital, Department of Pediatrics/Newborn Medicine, St. Louis, MO, USA.
概括
实施定制屏障模板和教育显著降低了婴儿非侵入性通风 (NIV) 的压力损伤 (PI). 这种干预措施降低了PI的发生率,改善了呼吸辅助期间的患者安全.
科学领域:
- 新生儿护理 新生儿护理
- 呼吸系统支持 呼吸系统支持
- 与医疗器械相关的并发症
背景情况:
- 非侵入性通风 (NIV) 对于管理出生时体重非常低的婴儿的呼吸困难至关重要,主要是为了预防支气管肺功能障碍.
- 然而,用于NIV的接口,如口罩和刺针,可以在这个脆弱的人群中引起压力损伤 (PI).
- 减少与NIV相关的PI (PI-NIV) 的发生率对于改善婴儿结果和护理质量至关重要.
研究的目的:
- 为了减少与用于非常低出生体重婴儿的非侵入性通风 (PI-NIV) 的口罩/接口相关的压力损伤的发生率.
- 实施和评估针对性的干预措施,重点关注障碍使用和接口配件,以减轻PI-NIV.
主要方法:
- 干预的重点是优化屏障应用,并确保适当的接口适合NIV设备.
- 开发定制的3D打印屏障模板,用于精确的床边屏障切割.
- 创建教育材料,以指导医疗保健提供者使用正确的接口装配和故障排除技术.
- 利用计划-做-研究-行动 (PDSA) 周期来代地改进干预措施.
主要成果:
- PI-NIV的总体发病率从每1000个NIV患者日下降了5.64至2.27.
- 更严重的,可报告的PI-NIV (阶段3-4和不可稳定) 的发病率从每1000个NIV患者日下降了1.13至0.
- 这些显著的减少在新协议实施后的研究期间观察到.
结论:
- 适当使用皮肤屏障和有针对性的教育计划是有效的,以尽量减少PI-NIV的风险.
- 这项研究表明,在接受NIV.的婴儿中,成功地减少了与设备相关的压力损伤的策略.
- 这种方法可以提高患者的安全性,并可能改善需要呼吸支持的婴儿的长期结果.
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