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评估成人机械通风患者的止痛/镇静方案的实施情况

Kristin Kaupp¹, Kaley MacKinnon², Jenna Vardy¹

¹Nova Scotia Health, Halifax, Nova Scotia.

Journal of the American Pharmacists Association : JAPhA

|December 3, 2025

概括

对机械通风成年人实施疼痛镇静方案,减少了13%的普罗波使用,并减少了22%的机械通风持续时间. 这项由药剂师主导的倡议改善了ICU患者的治疗结果.

科学领域:

关键护理医学关键护理医学
药理学药理学是指药理学的学科.
护理实践护理实践

背景情况:

基于协议的疼痛和镇静管理已被证明可以减少镇静剂的需求,机械通风的持续时间,ICU停留时间和危急病人疼痛.
针对机械通风成年患者,在2022年开发并实施了止痛/镇静方案.

研究的目的:

评估新的镇痛/镇静方案的实施和影响.
评估阿片类药物和镇静剂药物管理的变化.
确定对镇静水平和机械通风持续时间的影响.

主要方法:

一个由药剂师领导的多学科团队开发和实施了该协议.
使用单中心,回顾性,前后队列研究设计.
采用评估驱动的,逐步的,护士协议化的方法,使用标准化疼痛评估 (CPOT) 和镇静监测 (RASS).

主要成果:

与前协议组相比,后协议组的患者接受了13%较少的普罗波和14%更多的阿片类止痛药.
里士满兴奋镇静量表 (RASS) 和关键护理疼痛观察工具 (CPOT) 的中位数得分保持一致 (分别为-2和0).
实施后观察到机械通风持续时间 (22%的减少) 和ICU停留时间 (3.9%的减少) 的显著减少 (p < 0.001).

结论:

证实了成功实施了疼痛镇静方案.
该方案有效地减少了镇静剂 (propofol) 的暴露,同时增加了阿片类止痛药的使用.
观察到的机械通风持续时间和ICU停留时间的减少凸显了该方案对患者结果的积极影响.

关键词:

这是ABCDEF捆绑的ABCDEF捆绑.止痛药止痛药止痛药是一种止痛药.关键护理关键护理的关键护理解放的解放解放的解放镇静镇静是一种镇静.

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