在急性呼吸衰竭患者的机械通风中早期断奶的护士驱动的协议:试点研究
Jean-Adoumngar Moussanang1, Guillaume Thery2, Ophélie Marcq1
1CHU Reims, Unité de Médecine Intensive et Réanimation Polyvalente, F-51100 Reims, France.
Intensive & critical care nursing
|May 24, 2025
概括
一个护士驱动的协议在重症监护病房早期断奶显示了良好的遵守和接受. 这种方法有效地支持急性呼吸衰竭患者,即使在具有挑战性的健康危机期间也是如此.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 护理科学 护理科学
背景情况:
- 急性呼吸衰竭 (ARF) 需要在重症监护室 (ICU) 进行侵入性机械通风 (IMV).
- 早期断奶协议旨在减少通风时间和相关并发症.
- 护士驱动的协议可以赋予护理人员权力,并有可能改善患者的治疗结果.
研究的目的:
- 评估护士驱动的早期断奶协议的遵守和接受.
- 在ARF患者中评估该协议的有效性,从自发通风 (SV) 开始到输出管.
- 确定影响协议遵守和护士感知因素.
主要方法:
- 一个单一的前性试点研究,涉及ARF患者,需要IMV>48小时.
- 实施一项协议,包括在成功的SV试验后每3小时逐步降低压力支 (PS),FiO2和PEEP.
- 通过匿名调查 (0-10级) 评估协议遵守时间的百分比,并通过匿名调查 (0-10级) 通过协议和护士接受的协议.
主要成果:
- 该研究包括50名患者,其中60%患有COVID-19肺炎.
- 协议遵守率为76%,中位断奶协议持续时间为11天.
- 护士的接受度很高 (8/10),尽管工作量是一个明显的障碍 (5/10). 输出失败率为18%.
结论:
- 护士驱动的早期断奶协议在ICU护士中表现出良好的遵守和接受.
- 该协议是可行的和有效的,即使在COVID-19大流行的挑战.
- 纳入护理反对于完善ICU的通风断奶协议至关重要.
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