在重症监护室优化常规动脉血气检测的频率:一项观察性研究
James W Cuskelly1, Craig A McDonald2
1Intensive Care Unit, Cairns Hospital, Queensland, Australia; James Cook University, Townsville, Queensland, Australia.
减少ICU的常规动脉血气 (ABG) 测试显著降低了测试频率,但没有影响临界值检测或患者的结果. 这一协议变更证明了在重症监护机构的安全和有效的资源利用.
科学领域:
- 关键护理医学 关键护理医学
- 临床病理学 临床病理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 动脉血液气体 (ABG) 测试在重症监护室 (ICU) 经常被过度使用.
- 以前的研究表明,减少ABG采集频率不会对患者的结果产生负面影响.
- 这项研究调查了一项协议的影响,以减少常规ABG测试.
研究的目的:
- 评估减少常规动脉血液气体 (ABG) 采集频率的安全性和临床实用性.
- 评估对关键值检测,床边干预和患者结果的影响.
- 为了确定一个协议是否可以优化在ICU的ABG测试.
主要方法:
- 一项观察性研究比较了2019-2021年三个时期 (干预前,干预后,一年后续) 的情况.
- 在2020年2月在凯恩斯医院ICU实施ABG测试协议.
- 记录了ABG测试频率,临界值和床边干预措施 (例如呼吸支变化).
主要成果:
- 使用ABG显著下降,从4.93降至3.06测试/患者/天,在随访期间持续.
- 临界值的患者比例保持相似 (57%与49%),但每天临界值下降.
- 呼吸支变化和补充剂率没有显著降低;死亡率没有变化.
结论:
- 常规动脉血液气体 (ABG) 分析通常与ICU的过度测试有关.
- 一个常规的ABG采集协议,在员工教育的支持下,有效地减少了测试频率.
- 这种减少ABG测试并没有影响日常护理或患者的整体结果.
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