| 刘佐嘉,戈晓华.上海市重症监护室机械通气患儿镇静护理实践现状及影响因素调查[J].上海护理,2018,18(8): |
| 上海市重症监护室机械通气患儿镇静护理实践现状及影响因素调查 |
| Nurses’ sedation practices and influencing factors of children with mechanical ventilation in ICUs in Shanghai |
| DOI： |
| 中文关键词: 儿科危重症，机械通气，镇静评估，护理 |
| 英文关键词:pediatric intensive care, mechanical ventilation, sedation assessment |
| 基金项目:上海市卫计委科研基金项目资助，编号为201540175 |
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| 摘要点击次数: 2027 |
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| 中文摘要: |
| 目的：调查重症监护室机械通气患儿镇静护理实践现况并探讨其影响因素。 方法：采用自行设计一般资料问卷和护士镇静实践量表（中文版），对上海市3所三级甲等医院的220名儿童重症监护室护士以方便抽样方式进行横断面调查研究。 结果：儿童重症监护室护士自我报告式镇静实践行为平均得分为27.854.24，镇静意向得分3.701.02，镇静态度得分28.163.73。33.6%护士使用Ramsay镇静量表，16.4%护士使用舒适量表。多元回归分析显示，儿童重症监护室镇静实践行为受到护士年龄、职称、镇静态度、主观规范、知觉行为控制、镇静遗嘱目标和镇静意向所影响(F=22.27, P<0.001)，这些因素共同解释40.5%的镇静实践行为。 结论：总体而言，上海儿童重症监护室护士镇静评估会依据患儿行为表现与生理反应，需推荐使用舒适量表（CS）作为评估工具。明确护士在机械通气患儿镇静治疗管理中的角色地位，如此将有利于保证镇静患儿的安全与舒适。为了提高重症监护室护士镇静认知与实践能力，有必要丰富镇静实践的临床教学，更新“早期镇痛促进舒适，镇静剂量最小化和人文关怀最大化”的eCASH理念并促进“以患儿家庭为中心”的护理模式。 |
| 英文摘要: |
| Objective: To investigate current status and explore the relevant factors of nurses’ sedation practice on mechanically ventilated children in Shanghai ICU. Methods: A cross-section survey was conducted in pediatric ICUs of 3 tertiary hospitals, and 220 nurses were investigated by the Nurse Sedation Practice Scale (Chinese version) on electronic and paper-based questionnaires. Results: The average score of “self-reported sedation practices” of pediatric ICU nurses was 27.854.24. “Intention of sedation” scores 3.701.02. “Attitude of sedation” scores 28.163.73. Ramsay Sedation Scale (RSS) was used by 33.6% nurses as sedation assessment tool. Comfort Scale (CS) was only used by 16.4%. Multivariate regression analysis showed that pediatric ICUs sedation practices we influenced by age, job-title, sedation attitude, subjective norms, perceptual behavior control, sedation orders and goals and sedation intention (F=22.270, P<0.001), which could explain the 40.5% of sedation practice variance. Conclusion: The overall pediatric ICU nurses’ sedation is based on the behavior and physiological responses of children. This nursing practice is recommended to use the Comfort Scale (CS) as the assessment tool. The role of nurses in the management of sedative treatment in children with mechanical ventilation needs to be clarified to ensuring the safety and comfort of sedation. It’s necessary to enrich the clinical teaching of the sedation practice，update the “early Comfort using Analgesia, minimal Sedatives and maximal Humane care” eCASH concept and facilitate “family of children as the center” nursing model in order to improve the awareness and sedation practice of ICU nurses. |
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