经验式学习与胺:关于处方和知觉的混合方法探索性研究
Annette M Ilg1, Christine P Beltran2, Jenny A Shih3,4
1Division of Emergency Critical Care, Department of Emergency Medicine, Mass General Brigham, Boston, MA, USA.
Therapeutics and clinical risk management
|June 27, 2024
概括
尽管在COVID-19期间胺的使用增加,但重症治疗师仍然感到不舒服. 缺乏证据,经验和教育有助于这种不适,强调需要改善对重症监护中的胺的培训和协议.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 医学教育 医学教育
背景情况:
- 由于有限的数据和可变的接受度,在重症监护中使用胺仍有争议.
- 由于COVID-19大流行,需要快速适应镇静策略,包括针对严重急性呼吸困扰综合征 (ARDS) 的疼痛镇静.
研究的目的:
- 为了研究如何临床经验与胺影响密集主义者的看法和态度.
- 分析COVID-19爆发前和爆发期间的胺处方模式.
主要方法:
- 混合方法研究结合了定量胺处方数据和定性焦点组数据.
- 在COVID-19前 (2019年) 和COVID-19激增 (2020年) 期间,在高等学术ICU中分析处方模式.
- 使用框架方法分析了两个重点小组,其中包括重症监护人员.
主要成果:
- 与COVID-19前 (2.1%) 相比,在COVID-19期间 (32.3%) 胺的处方显著增加.
- 尽管使用量增加,重症治疗师报告不适,理由是缺乏证据,个人经验,需要教育/协议.
- 13名重症监护人员参加了重点小组 (8名COVID前,5名COVID后).
结论:
- 在COVID-19期间增加胺类药物处方并没有减少强度医生的不适.
- 导致不适的关键因素包括证据有限,个人经验不足,以及对提高教育和标准化协议的渴望.
- 调查结果强调需要改进重症监护课程,并改进关于使用胺的继续教育的流程.
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