在重症监护室自发唤醒和呼吸试验中的实践模式
Rebecca H Rozsa1, Christoph M Lecznar2, Caitlin M Matzke3
1Rebecca H. Rozsa is a nurse practitioner in the medical respiratory intensive care unit, Pulmonary and Critical Care Medicine, VCU Health System, Richmond, Virginia.
实施自发觉醒和呼吸试验教育改善了自发觉醒试验的遵守. 然而,单独的专业间教育在整体试验采用方面取得了适度的改善,并没有显著改变患者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 提高质量 提高科学 提高质量
- 医疗保健教育 医疗保健教育
背景情况:
- 自发唤醒和呼吸试验 (SABT) 是基于证据的干预措施.
- 在临床实践中采用SABT协议的不一致性需要调查.
- 一个学术医疗中心发现需要量化SABT实践模式.
研究的目的:
- 调查和量化自发觉醒和呼吸试验的实践模式.
- 评估质量改进计划对SABT合规性的影响.
主要方法:
- 实施了一项质量改进项目.
- 基于冠军的教育被用于员工培训.
- 电子健康记录数据被用来量化实践模式.
主要成果:
- 88.9%的ICU工作人员完成了SABT教育.
- 对自发觉醒试验的遵守率显著增加 (30.1%,P < .001).
- 遵守自发呼吸试验显示无意义的增加 (12.4%,P = .10).
- 关键时间间隔和患者结果 (机械呼吸持续时间,再输管率) 保持不变.
结论:
- 量化实践模式和定义SABT的合规性是可行的.
- 专业间教育本身可能只会适度地提高SABT的合规性.
- 可能需要进一步的战略来加强SABT的实施和问责制.
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