有效沟通提高ICU气管插管患者保留人工气道依从性

Effective Communication for Better Compliance of Artificial Airway Patients in ICU

目的探讨ICU气管插管的清醒患者保留人工气道的有效沟通方法以提高患者保留人工气道的依从性。方法对2005年12月-2006年12月ICU收治的164例气管插管患者实施沟通计划:对初次插管患者沟通工作做在前;对插管后入ICU的患者立即进行宣教,对于听不懂医生的话、不识字或无书写能力的患者采取无声交流(应用图画板或词组卡片),对短期应用机械通气、神志清楚的患者采取手势法进行无声交流,对清醒、双手能活动的患者采取用纸和笔写字的方式进行无声交流;置管持续期间及时反馈沟通效果,个别病例重点交班;规范护理常规,检查等操作过程中做好解释工作。结果气管插管患者自行拔管率实施有效沟通后,从6.6%下降到了1.8%。结论沟通与宣教能提高气管插管患者对人工气道依从性,使气管插管自行拔管率降低。

Objective To study the effective communication for better compliance of artificial airway patients in ICU. Methods The communication strategy was conducted among 164 artificial airway patients in ICU from Dec. 2005 to Dec. 2006. Communication was preceded before intubation for those undergoing it for the first time, and for those having intubation, instructions were performed as soon as possible. For those illiterate, unable to understand doctors, silent communications were conducted via drawing pad and word cards. For those conscious with short-time artificial airway, silent communication was used via signs, while for those conscious and their hands movable, the silent communication via pencils and paper. During intubation, the feedback of communication effect was noted in time among nurses and individual critical case was reported during shifts. Nursing routines were standardized and explana- tion was well made. Results The rate of self-withdrawal by the patients decreased from 6.6% to 1.8% after effective communication. Conclusion Communication and health education are helpful to enhance compliance of artificial airway patients in ICU, thus decreasing the rate of self-withdrawal.