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生命末期重症监护:实施一套基于加拿大指导方针的命令,在重症监护病房中取消维持生命的治疗
Alison Knapp1, Jennifer M O'Brien1, Maria Cruz1
1Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Palliative medicine reports
|May 1, 2025
概括
在重症监护室 (ICU) 实施加拿大终身护理指南改善了症状评估和整体护理. 虽然增加了文书工作,但这项干预措施支持了患者和家人的高质量的终身护理.
科学领域:
- 关键护理医学 关键护理医学
- 抚慰性护理是一种缓解性护理.
- 医疗保健 实施 科学 科学
背景情况:
- 越来越多的患者在重症监护室 (ICU) 接受终身护理.
- 停止维持生命治疗是ICU中死亡的常见途径.
- 加拿大共识指导方针存在,以规范ICU的生命终端护理实践.
研究的目的:
- 评估在两个萨斯喀彻温州的ICU中实施加拿大终身护理指南的可行性和可接受性.
- 评估标准化订单组,护理流程和护理计划对终身护理的影响.
- 了解指南实施对医疗保健提供者的经验和患者结果的影响.
主要方法:
- 采用了混合有效性-实施研究设计.
- 在为期六个月的试点期间,一个指导委员会指导了实施过程.
- 数据收集包括实施前,实施期间和实施后的阶段,使用调查,采访和患者病历审查.
主要成果:
- 干预材料增加了提供者的工作负担,但促进了高质量的终身护理,并减少了道德紧张局势.
- 没有观察到镇静剂剂量的显著变化,也没有观察到抽后死亡时间的显著变化.
- 在实施后,标准化症状评估 (疼痛,呼吸不全,兴奋) 和整体护理结果的改善显著增加.
结论:
- 加拿大对ICU终身护理的最佳实践指南通过多学科方法成功实施.
- 该研究提供了关于将标准化症状评估和药物定位整合到ICU的见解.
- 这些发现支持将标准化工具纳入复杂的重症监护环境中,以加强终身护理.
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