在重症监护室接受机械通风的患者改变镇静实践的障碍:临床工作人员的定性采访研究
Nicholas D Richards1,2, Hilary L Bekker3, Simon J Howell2
1Adult Critical Care, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Nursing in critical care
|January 15, 2026
概括
改善机械通风患者的镇静需要解决工作人员的看法,ICU文化和培训. 优先考虑镇静作为以领导支持为目标的治疗,是改善患者治疗结果的关键.
科学领域:
- 关键护理医学 关键护理医学
- 护理研究 护理研究
- 患者安全 患者安全
背景情况:
- 医疗镇静对于在重症监护室 (ICU) 接受机械呼吸的患者至关重要.
- 虽然降低了患者的痛苦,但镇静可以导致低血压和妄想等不良影响.
- 优化镇静实践对于改善ICU患者治疗结果至关重要.
研究的目的:
- 探索重症监护室 (ICU) 工作人员对当前镇静实践的经验.
- 确定改善和创新镇静方案的障碍和促进因素.
- 通过更好的镇静管理来提高患者护理.
主要方法:
- 一项定性研究,涉及对18名ICU医护人员进行半结构面试.
- 在英格兰约克郡的两个NHS成人重症监护室进行了采访.
- 数据分析采用了由布劳恩和克拉克的六阶段方法指导的反射主题分析.
主要成果:
- 出现了四个主题:员工对镇静目标的看法,ICU文化的影响,镇静教育和培训需求以及影响变化的因素.
- 确定的主要障碍包括优先级不足,文化规范,员工保留和工作量.
- 创新的促进者包括将镇静视为积极的,以目标为导向的治疗.
结论:
- 镇静实践受到临床框架,文化,教育和组织压力的影响.
- 优化镇静需要将其作为主动治疗的优先考虑.
- 结构化的教育和领导层的参与对于成功的镇静实践创新至关重要.
相关概念视频
Mechanical Ventilation II: Invasive Ventilation
625
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
625
Mechanical Ventilation I: Indication and Settings
2.5K
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
2.5K
Endotracheal Intubation II: Nursing Management
2.4K
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
2.4K
Tracheostomy Decannulation
1.2K
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
1.2K
Mechanical Ventilation III: Noninvasive Ventilation
512
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
512
Cardiopulmonary Resuscitation II: ACLS Airway Management
524
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
524


