喀土穆重症监护室医生的谵妄管理和当前做法

Sheema Hamid Seidna Hamid, Ghada Omer Hamad AbdD El-Raheem, Hana Eltayeb Salih Elamin, Mudawi Mohammed Ahmed Abdallah
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摘要

谵妄是一种大脑功能障碍,其特点是注意力和认知能力出现波动性紊乱。国际指南建议每天进行谵妄筛查。重症监护病房意识混乱评估方法(CAM-ICU)和重症监护谵妄筛查核对表(ICDSC)是评估谵妄最常用的方法。本研究旨在找出知识和实践方面的障碍和差距。这是一项基于医院的横断面研究。本研究采用分层随机抽样法。随机抽取了 72 名 ICU 医生。使用 IBM SPSS 23 版本进行统计分析。研究采用描述性数据,并使用卡方检验来确定变量之间的关联。统计显著性以 p < 0.05 为标准。超过 70% 的医生年龄小于 30 岁,且为女性。69.4%的参与者工作经验小于 1 年。总共有 94.4% 的参与者在重症监护病房工作。只有不到 20% 的医生使用过谵妄评估工具,不同经验的医生使用谵妄评估工具的比例存在显著差异(P=0.012)。13.9%的患者未定期进行谵妄评估。76.4%的医生采用了非药物治疗方法,与患者的沟通最为频繁(75%)。氟哌啶醇是最常用的药物(83.3%)。共有 40.3% 的医生在重症监护室出院时没有停止谵妄药物治疗。定期进行谵妄评估。然而,使用有效评估工具的情况并不常见。对谵妄进行非药物治疗非常重要,而且大多数情况下都会这样做。我们的医生为两种形式的谵妄开具了抗精神病药物,其中近一半的医生在 ICU 出院时没有停药。对症下药以及与患者的下一任负责人联系非常重要。
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Delirium management and current practice among Intensive Care Units Doctors, Khartoum
Delirium is a brain dysfunction characterized by attention and cognitive disturbances in a fluctuating manner. The international guidelines recommend daily screening for delirium. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) are the most commonly used methods for assessing delirium. This study aimed to identify barriers and gaps in knowledge and practice. This was a hospital-based Cross-Sectional study. Stratified random sampling was used in this study. 72 ICU doctors were randomly selected. Statistical analyses were performed using IBM SPSS version 23. Descriptive data were presented, and the chi-squared test was used to determine the associations among variables. Statistical significance was set at p < 0.05. More than 70% of the doctors were ≤ 30 years of age and female. A total of 69.4% of the participants had < 1year of experience. In total, 94.4% of the participants worked in medical ICUs. Less than 20% of the doctors used delirium assessment tools, with a statistically significant difference based on experience (p=0.012). Delirium was not regularly assessed in 13.9% of the patients. Non-pharmacological management was applied by 76.4% of doctors, and communication with patients was the most frequent (75%). Haloperidol was the most commonly used drug (83.3%). A total of 40.3% of doctors did not stop delirium medication on ICU discharge. A regular delirium assessment was performed. However, the use of validated assessment tools is uncommon. Nonpharmacological management of delirium is important and is mostly performed. Our doctors prescribed antipsychotics for the treatment of both forms of delirium, and almost half of them did not stop the medications on ICU discharge. Medication reconciliation and contact with the next in-charge of the patients are important.
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