在重症成人患者中优化镇静实践的促进因素和障碍:定性研究
Theophany Eystathioy1, Claudia Singh1, Daniel J Niven2
1Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
Intensive & critical care nursing
|February 8, 2026
概括
医疗保健提供者确定了影响镇静实践的关键因素,包括信仰,资源和社会角色. 协议驱动的镇静策略可以通过解决这些领域来改善指导方针的遵守.
科学领域:
- 关键护理医学 关键护理医学
- 改善医疗保健质量 改善医疗保健质量
- 在医疗保健中的行为科学.
背景情况:
- 在重症监护室 (ICU) 的镇静实践是复杂的,受到多种因素的影响.
- 优化镇静对于患者的治疗结果和资源管理至关重要.
- 了解提供者的观点对于有效实施镇静指南至关重要.
研究的目的:
- 确定影响医疗保健提供者镇静实践的优先领域.
- 描述镇静实践变化的促进者和障碍者.
- 为制定镇静方案的有针对性的实施策略提供信息.
主要方法:
- 与29名重症监护医疗保健提供者 (医生,国家医生,护士,药剂师,RT,PT) 进行了定性半结构面试.
- 使用理论领域框架 (TDF) 进行演性内容分析.
- 确定影响镇静实践的优先TDF领域.
主要成果:
- 确定了七个优先级的TDF领域:关于后果的信念,关于能力的信念,强化,记忆/注意力/决策过程,环境背景/资源,社会影响力和社会/专业角色.
- 镇静剂用于患者/工作人员安全,单位文化,以及管理环境/组织挑战.
- 建议包括针对特定人群的护理驱动的协议和镇静断奶策略.
结论:
- 临界护理提供者确定了患者/工作人员安全,患者特异性因素和社会环境因素是对镇静实践的关键影响.
- 协议驱动镇静的实施策略应针对确定优先领域和驱动因素.
- 解决这些领域提高了镇静方案实施和准则遵守成功的可能性.
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