Objective To investigate bacteria spectrum of the sputum collected from patients with artificial airway and explore the nursing strategy of preventing and reducing pulmonary infection. Methods 136 sputum samples are o...Objective To investigate bacteria spectrum of the sputum collected from patients with artificial airway and explore the nursing strategy of preventing and reducing pulmonary infection. Methods 136 sputum samples are obtained by endotracheal tube suction hrough disposable closed suction catheter or brochoscopy sterile brush。展开更多
目的构建急诊抢救室气管切开患者人工气道管理方案,并探讨其应用价值。方法通过查阅文献、总结临床经验,采用Delphi法构建急诊抢救室气管切开患者人工气道管理方案。前瞻性选取2022年2~11月首都医科大学附属北京同仁医院急诊抢救室收治...目的构建急诊抢救室气管切开患者人工气道管理方案,并探讨其应用价值。方法通过查阅文献、总结临床经验,采用Delphi法构建急诊抢救室气管切开患者人工气道管理方案。前瞻性选取2022年2~11月首都医科大学附属北京同仁医院急诊抢救室收治的141例实施气管切开术的患者作为研究对象,采用随机数字表法分为改良组与传统组。传统组采用常规人工气道管理干预,改良组采用基于Delphi法构建的人工气道管理方案干预,2组均连续干预至转出本科室。比较2组患者临床指标、痰液性状、动脉血气指标及术后并发症。结果改良组建立人工气道时间、机械通气时间、单次吸痰时间短于传统组,每日吸痰次数少于传统组,首次插管成功率高于传统组,差异有统计学意义(P<0.05)。干预1 d、干预3 d改良组患者痰液性状明显优于传统组,差异有统计学意义(P<0.05)。与干预前比较,2组患者干预1 d及干预3 d PaO_(2)呈现上升趋势,且各个时点之间比较差异有统计学意义(P<0.05);但组间、组间时点交互比较差异无统计学意义(P>0.05);与干预前比较,2组患者干预1 d及干预3 d PaCO_(2)均呈现出下降趋势,且各个时点,组间与时点交互比较差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05)。比较2组患者术后并发症,改良组明显低于传统组,差异有统计学意义(P<0.05)。结论构建急诊抢救室气管切开患者人工气道管理方案可有效减少术后并发症、缩短建立人工气道、机械通气与单次吸痰时间,减少吸痰次数,提高首次插管成功率,改善痰液性状。展开更多
BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of v...BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia.Nonetheless,existing research has largely overlooked the understanding,beliefs,and practical dimensions of airway airbag management among ED nurses,with a predominant focus on intensive care unit nurses.AIM To investigate the current status of ED nurses'knowledge,beliefs,and practical behaviors in airway airbag management and their influencing factors.METHODS A survey was conducted from July 10th to August 10th,2023,using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai.Pathway analysis was utilized to analyze the influencing factors.RESULTS The scores for ED nurses'airway airbag management knowledge were 60.26±23.00,belief was 88.65±13.36,and behavior was 75.10±19.84.The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training,department,and work experience in the department.Influencing factors of airbag management belief comprised knowledge,department,and participation in specialized nurse or mechanical ventilation training.Primary influencing factors of airbag management behavior included knowledge,belief,department,participation in specialized nurse or mechanical ventilation training,and professional title.The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior,with a total effect value of 0.513,and an indirect effect of 0.085,constituting 16.6%of the total effect.CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices,yet there remains room for improvement in their knowledge levels.Nursing managers should implement interventions tailored to the characteristics of ED nurses'airbag management knowledge,beliefs,and practices to enhance their airbag management proficiency.展开更多
Background: Noninvasive ventilation (NIV) is an important therapeutic modality for the treatment of acute respiratory failure (ARF). In this review, we critically analyze randomized controlled trials on the most used ...Background: Noninvasive ventilation (NIV) is an important therapeutic modality for the treatment of acute respiratory failure (ARF). In this review, we critically analyze randomized controlled trials on the most used NIV interfaces in the treatments of ARF. Methods: The searches were conducted in the Medline, Lilacs, PubMed, Cochrane, and Pedro databases from June to November 2021. The inclusion criteria were Randomized clinical trials (RCTs) published from 2016 to 2021 in Portuguese, Spanish, or English and involving adults (aged ≥ 18 years). The eligibility criteria for article selection were based on the PICO strategy: Population—Adults with ARF;Intervention—NIV Therapy;Comparison—Conventional oxygen therapy, high-flow nasal cannula (HFNC) oxygen therapy, or NIV;Outcome—improvement in ARF. The search for articles and the implementation of the inclusion criteria were independently conducted by two researchers. Results: Seven scientific articles involving 574 adults with ARF due to various causes, such as chest trauma, decompensated heart failure, coronavirus disease 2019 (COVID-19), and postoperative period, among others, were included. The interfaces cited in the studies included an oronasal mask, nasal mask, full-face mask, and helmet. In addition, some favorable outcomes related to NIV were reported in the studies, such as a reduction in the rate of orotracheal intubation and shorter length of stay in the ICU. Conclusions: The most cited interfaces in the treatment of ARF were the oronasal mask and the helmet.展开更多
文摘Objective To investigate bacteria spectrum of the sputum collected from patients with artificial airway and explore the nursing strategy of preventing and reducing pulmonary infection. Methods 136 sputum samples are obtained by endotracheal tube suction hrough disposable closed suction catheter or brochoscopy sterile brush。
文摘目的构建急诊抢救室气管切开患者人工气道管理方案,并探讨其应用价值。方法通过查阅文献、总结临床经验,采用Delphi法构建急诊抢救室气管切开患者人工气道管理方案。前瞻性选取2022年2~11月首都医科大学附属北京同仁医院急诊抢救室收治的141例实施气管切开术的患者作为研究对象,采用随机数字表法分为改良组与传统组。传统组采用常规人工气道管理干预,改良组采用基于Delphi法构建的人工气道管理方案干预,2组均连续干预至转出本科室。比较2组患者临床指标、痰液性状、动脉血气指标及术后并发症。结果改良组建立人工气道时间、机械通气时间、单次吸痰时间短于传统组,每日吸痰次数少于传统组,首次插管成功率高于传统组,差异有统计学意义(P<0.05)。干预1 d、干预3 d改良组患者痰液性状明显优于传统组,差异有统计学意义(P<0.05)。与干预前比较,2组患者干预1 d及干预3 d PaO_(2)呈现上升趋势,且各个时点之间比较差异有统计学意义(P<0.05);但组间、组间时点交互比较差异无统计学意义(P>0.05);与干预前比较,2组患者干预1 d及干预3 d PaCO_(2)均呈现出下降趋势,且各个时点,组间与时点交互比较差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05)。比较2组患者术后并发症,改良组明显低于传统组,差异有统计学意义(P<0.05)。结论构建急诊抢救室气管切开患者人工气道管理方案可有效减少术后并发症、缩短建立人工气道、机械通气与单次吸痰时间,减少吸痰次数,提高首次插管成功率,改善痰液性状。
文摘BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia.Nonetheless,existing research has largely overlooked the understanding,beliefs,and practical dimensions of airway airbag management among ED nurses,with a predominant focus on intensive care unit nurses.AIM To investigate the current status of ED nurses'knowledge,beliefs,and practical behaviors in airway airbag management and their influencing factors.METHODS A survey was conducted from July 10th to August 10th,2023,using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai.Pathway analysis was utilized to analyze the influencing factors.RESULTS The scores for ED nurses'airway airbag management knowledge were 60.26±23.00,belief was 88.65±13.36,and behavior was 75.10±19.84.The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training,department,and work experience in the department.Influencing factors of airbag management belief comprised knowledge,department,and participation in specialized nurse or mechanical ventilation training.Primary influencing factors of airbag management behavior included knowledge,belief,department,participation in specialized nurse or mechanical ventilation training,and professional title.The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior,with a total effect value of 0.513,and an indirect effect of 0.085,constituting 16.6%of the total effect.CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices,yet there remains room for improvement in their knowledge levels.Nursing managers should implement interventions tailored to the characteristics of ED nurses'airbag management knowledge,beliefs,and practices to enhance their airbag management proficiency.
文摘Background: Noninvasive ventilation (NIV) is an important therapeutic modality for the treatment of acute respiratory failure (ARF). In this review, we critically analyze randomized controlled trials on the most used NIV interfaces in the treatments of ARF. Methods: The searches were conducted in the Medline, Lilacs, PubMed, Cochrane, and Pedro databases from June to November 2021. The inclusion criteria were Randomized clinical trials (RCTs) published from 2016 to 2021 in Portuguese, Spanish, or English and involving adults (aged ≥ 18 years). The eligibility criteria for article selection were based on the PICO strategy: Population—Adults with ARF;Intervention—NIV Therapy;Comparison—Conventional oxygen therapy, high-flow nasal cannula (HFNC) oxygen therapy, or NIV;Outcome—improvement in ARF. The search for articles and the implementation of the inclusion criteria were independently conducted by two researchers. Results: Seven scientific articles involving 574 adults with ARF due to various causes, such as chest trauma, decompensated heart failure, coronavirus disease 2019 (COVID-19), and postoperative period, among others, were included. The interfaces cited in the studies included an oronasal mask, nasal mask, full-face mask, and helmet. In addition, some favorable outcomes related to NIV were reported in the studies, such as a reduction in the rate of orotracheal intubation and shorter length of stay in the ICU. Conclusions: The most cited interfaces in the treatment of ARF were the oronasal mask and the helmet.
