植入式心脏转换器除器的存在很少在代码状态更改期间得到解决
Namratha Seetharam Meda1, Watipa Makhumalo2, Hunter Groninger3,4
1Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA.
The American journal of hospice & palliative care
|June 22, 2024
概括
在对高风险患者的终身护理过程中,很少记录有关植入式心脏转换器除器 (ICD) 偏好的讨论. 提高临床医生的教育和ICD的图表可见性至关重要.
科学领域:
- 心脏病学 心脏病学
- 医学伦理 医学伦理
- 抚慰性护理是一种缓解性护理.
背景情况:
- 植入式心脏转移器除器 (ICD) 防止心脏突然死亡,但可以在终身护理期间提供不必要的冲击.
- 关于ICD停用的讨论对于临终期的患者来说至关重要.
研究的目的:
- 在不复苏 (DNR) 代码状态对话期间,确定可植入心脏转换器除器 (ICD) 偏好讨论的频率.
- 确定与高风险患者ICD禁用讨论的文档相关的因素.
主要方法:
- 对涉及ICD,DNR状态变化和随后死亡的患者住院的回顾性图表审查.
- 数据分析包括人口统计,并发症和ICD讨论的文档,以及统计学意义测试.
主要成果:
- 在129名患者中,110名 (85.3%) 缺乏关于ICD停用的记录讨论.
- 根据患者特征,临床医生类型或息护理咨询,没有发现显著差异.
- 特别提到输管或心脏转换的讨论与ICD停用讨论有关.
结论:
- 关于ICD停活的记录讨论在临终高风险患者中很少发生.
- 需要提高ICD的图表可见性,并为临床医生提供针对性的关于终身护理讨论的针对性教育.
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