气管内吸引过程中的疼痛管理:来自中国外科重症监护病房的宝贵经验

Q4 Nursing Frontiers of Nursing Pub Date : 2022-03-01 DOI:10.2478/fon-2022-0003
Qianwen Ruan, Maneewat Khomapak, Hathairat Sangchan
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引用次数: 0

摘要

摘要目的比较疼痛管理方案和常规抽吸方法对重症监护病房成人疼痛存在和躁动水平的影响。传播循证疼痛管理干预措施的实施结果,以减少气管内管吸引(ETS)期间的疼痛和躁动,并将关键发现转化为临床护理实践。方法对2018年昆明医科大学第二附属医院外科重症监护病房(SICU)收治的成人进行两组后测设计的准实验研究。52名符合研究资格的成年人在同意后被纳入研究,每组26人。对照组患者接受常规护理,干预组患者接受干预以减少躁动和疼痛相关的ETS。采用中文版重症疼痛观察工具(CPOT)和Richmond躁动镇静量表(RASS)在5个测量时间点测量干预对疼痛存在和躁动水平的影响。结果干预组在抽吸时、吸后即刻及吸后5min疼痛水平均有统计学意义的降低。干预组在抽吸过程中和抽吸后的躁动程度显著降低。结论与通常的ETS实践相比,研究结果支持循证的疼痛相关ETS管理干预措施的积极缓解疼痛效果。研究干预措施足够有效和安全,以维持未通气气道的清洁和未通气的标准化吸痰,并有助于缓解疼痛。因此,基于证据的疼痛相关ETS管理干预值得推荐用于SICU患者以及其他需要吸痰的患者。值得注意的是,将先发制人的镇痛处方和给药与非药物干预相结合在实现疼痛缓解中起着至关重要的作用。
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Inter-Professional-Compassionate pain management during endotracheal suctioning: a valuable lesson from a Chinese surgical intensive care unit
Abstract Objective To compare the effects of a pain management program and routine suctioning methods on the level of pain presence and agitation in Chinese adults admitted to the intensive care unit. To disseminate the results from the implementation of the evidence-informed pain management interventions for reducing pain presence and agitation during endotracheal tube suctioning (ETS) and translate the key finding to clinical nursing practice. Methods A quasi-experimental study of a two-group post-test design was conducted in adults admitted after surgery to a surgical intensive care unit (SICU) of the Second Affiliated Hospital of Kunming Medical University, Yunnan, China in 2018. Fifty-two adults who met the study eligibility were included after consent, 26 in each group. Patients in the control group received usual care while patients in the intervention group received interventions to reduce agitation and pain-related ETS. The impacts of the intervention on the level of pain presence and agitation were measured at 5 measuring time points using the Chinese versions of Critical-Care Pain Observation Tool (CPOT) and Richmond Agitation Sedation Scale (RASS). Results The level of pain presence in the intervention group statistically significantly decreased during, immediately after, and 5 min after suctioning. The level of agitation in the intervention group significantly decreased during and immediately after suctioning. Conclusions The findings provide support for the positive pain-relieving effects of the evidence-informed pain-related ETS management interventions when compared with the usual ETS practice. The study interventions were sufficiently effective and safe to maintain patent airway clean and patent as standardized suctioning and helps pain relief. So, evidence-based pain-related ETS management intervention is worthy of recommending to utilize in SICU patients as well as other patients who required suctioning. It is worth noting that integrating pre-emptive analgesia prescription and administration with non-pharmacological intervention plays a critical role in achieving pain relief.
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来源期刊
Frontiers of Nursing
Frontiers of Nursing Nursing-Nursing (all)
CiteScore
0.70
自引率
0.00%
发文量
38
审稿时长
16 weeks
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