通过使用文档分析,对非侵入性先进呼吸辅助的终身护理退休指南进行国家审查
David Wenzel1,2, Thomas Jefferies3, Rachel Davies4
1Population Health Sciences, University of Leicester, Leicester, UK dw343@leicester.ac.uk.
BMJ open
|October 16, 2024
概括
这项研究分析了NHS关于撤销非侵入性高级呼吸辅助的指导方针,发现普遍一致,但强调了氧疗法和断奶实践的关键差异,表明需要进一步研究.
科学领域:
- 临床实践指南 临床实践指南
- 呼吸系统支持 呼吸系统支持
- 在生命末期的护理.
背景情况:
- 非侵入性高级呼吸辅助,包括持续正气道压力 (CPAP) 和非侵入性通风 (NIV),经常用于终身护理.
- 对于这种支持,提供撤回指南的高质量研究是有限的.
- 了解当前的实践变化对于患者护理至关重要.
研究的目的:
- 分析NHS发布的关于终身停用非侵入性高级呼吸辅助器械的指导方针的范围.
- 在当前的临床指南中确定共识和不一致的领域.
- 建立未来研究的基础,以解决已识别的差距.
主要方法:
- 雪球采样用于收集NHS发布的指导方针.
- 使用文档分析,采用混合的诱导和演框架分析方法.
- 分析了20条指导方针,数据和是在15日后实现的.
主要成果:
- 共同的主题包括法律/道德框架,决策,戒断过程,戒断后护理和息护理咨询.
- 在指导方针中,在最佳实践的许多方面都发现了重大共识.
- 在戒断后的氧气治疗和压力断奶策略方面出现了关键的不一致性.
结论:
- 这项研究为非侵入性高级呼吸辅助的戒断实践的总体一致性提供了保证.
- 确定了不一致的领域,强调了迫切需要进一步研究.
- 需要基于证据的建议来支持临床医生,患者和家庭在这些重症监护事件期间.
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