重症监护护士在机械通气患者中实施“ABCDE束”的实践

E. Elkady, Nahla Khalil, M. Elshafey, F. Reshia
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引用次数: 0

摘要

重症监护病房(ICU)患者,特别是接受机械通气(MV)的患者的主要并发症之一是谵妄,谵妄是一种意识、注意力、认知和知觉的障碍,通常在数小时至数天的短时间内发生,并在一天中趋于波动。谵妄与死亡率增加、机械通气时间延长和住院时间延长有关。ABCDE是苏醒和呼吸协调、谵妄监测/管理和早期运动/活动捆绑的缩写,已被提出作为icu中跨学科、多组分的干预措施,以减少谵妄的发生率。研究目的:本研究旨在评价在Damietta医院机械通气患者中实施ABCDE束对减少谵妄的效果。方法:采用准实验研究的干预前/干预后设计进行本研究,以证明干预与结果之间的因果关系。该研究在Damietta胸病医院ICU进行。有目的的样本包括65名年龄在18至60岁之间的男女成人机械通气危重患者。使用镇静和谵妄评估工具。结果:本研究表明,机械通气的患者接受ABCDE捆绑治疗后,谵妄症状比接受ABCDE捆绑治疗前(常规护理)少。所以;干预前后患者谵妄评分差异有统计学意义,x2=52.52, p值=0.001*
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Critical care nurses’ practices in implementing the “ABCDE bundle” among mechanically ventilated patients
One of the principal complications in patients in the intensive care unit (ICU), particularly in those receiving mechanical ventilation (MV), is delirium, which is a disturbance of consciousness, attention, cognition and perception that develops over a short period of time usually hours to days and tends to fluctuate during the course of the day .It is associated with increased mortality, prolonged mechanical ventilation, and prolonged hospital length of stay (LOS). The ABCDE is stand for Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility bundle that has been proposed as an interdisciplinary, multi-component intervention in ICUs to reduce incidence of delirium. Aim of study: this study aims to evaluate the effect of implementing the ABCDE bundle on reduction of delirium among mechanically ventilated patients at Damietta hospital. Methods: A quasi experimental research pre/post intervention design will be used to conduct this study to demonstrate causality between an intervention and an outcome. The study was carried out at ICU of Damietta Chest Disease Hospital. A purposive sample of 65 adult mechanically ventilated critically patients aged between 18 and 60 of both sexes will be included. Sedation and Delirium assessment tools are used. Result: This study shows that mechanically ventilated patients who exposed to implementation of ABCDE bundle were experienced less delirium signs than prior to ABCDE bundle implementation (usual care). So; there were significant differences in delirium scores among the studied patients before and after intervention with x2=52.52 and p-value=0.001*
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