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对经验丰富的重症监护病房护士的心脏手术后出血的临床决策进行了维度分析
Patrick Lavoie1,2, Caroline Arbour1,3, Amélie Blanchet Garneau1,4
1Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada.
Nursing in critical care
|July 12, 2024
概括
经验丰富的重症监护护士使用警和识别出血的尺寸,在心脏手术后做出关键决策. 他们的专业知识和适应能力是有效管理术后出血的关键.
科学领域:
- 临界护理护理重症监护护理
- 进行心血管外科手术.
- 患者安全 患者安全
背景情况:
- 心脏手术后出血是一种常见且严重的并发症.
- 在了解重症监护护护士如何处理这种并发症方面存在知识差距.
- 经验丰富的护士的决策过程对于患者的结果至关重要.
研究的目的:
- 描述经验丰富的重症监护室 (ICU) 护士在心脏手术后管理出血时的临床决策.
- 探索在这些关键情况下影响护士判断和行动的因素.
主要方法:
- 使用基于认可的决定模型进行定性研究.
- 与39名经验丰富的ICU护士进行了半结构面试,使用了批判性决策方法.
- 使用维度分析分析的数据.
主要成果:
- 护士们表现出警,认识到出血的出血和低血压维度.
- 决策涉及监测,确定原因,停止出血,血液动力学稳定,以及患者/家庭的支持.
- 根据当地实践,自治,跨专业动态和资源,采取了适应性的行动.
结论:
- 护士的决策受个人属性,患者状况和上下文因素的影响.
- "可操作性"的核心概念解释了它们在局势约束下采取行动的能力.
- 专业知识使护士能够预测和适应各种出血情景.
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