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
目的:构建一套适用于三级甲等医院急诊抢救室患者的护理难度评价指标体系。方法:通过半结构式访谈并参考国内外关于护理难度指标的相关文献,初步拟定护理难度评价指标,采用德尔菲法对20名专家进行两轮函询。结果:构建了包含4个一级指标...目的:构建一套适用于三级甲等医院急诊抢救室患者的护理难度评价指标体系。方法:通过半结构式访谈并参考国内外关于护理难度指标的相关文献,初步拟定护理难度评价指标,采用德尔菲法对20名专家进行两轮函询。结果:构建了包含4个一级指标(病情严重程度、护理操作难度、护理资源需求、患者及家属配合度)和15个二级指标的三级甲等医院急诊抢救室患者护理难度评价指标体系。结论:本研究构建了急诊抢救室患者护理难度评价指标体系,具有一定的临床适用性,下一步将进行实证检验,以期为临床护理提供实用的护理难度评估工具。Objective: To construct a set of nursing difficulty evaluation index system applicable to patients in the emergency rescue room of a tertiary hospital. Methods: Through semi-structured interviews and reference to relevant literature on nursing difficulty indicators at home and abroad, the evaluation indicators of nursing difficulty were initially formulated, and two rounds of correspondence were conducted with 20 experts using the Delphi method. Results: A nursing difficulty evaluation index system for patients in the emergency rescue room of a tertiary-level A hospital was constructed, which included four primary indicators (severity of illness, difficulty of nursing operation, demand for nursing resources, and cooperation of patients and their families) and 15 secondary indicators. Conclusion: This study constructed a nursing difficulty evaluation index system for patients in the emergency rescue room, which has certain clinical applicability, and will be empirically tested in the next step, with the aim of providing a practical nursing difficulty assessment tool for clinical care.展开更多
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。
文摘目的:构建一套适用于三级甲等医院急诊抢救室患者的护理难度评价指标体系。方法:通过半结构式访谈并参考国内外关于护理难度指标的相关文献,初步拟定护理难度评价指标,采用德尔菲法对20名专家进行两轮函询。结果:构建了包含4个一级指标(病情严重程度、护理操作难度、护理资源需求、患者及家属配合度)和15个二级指标的三级甲等医院急诊抢救室患者护理难度评价指标体系。结论:本研究构建了急诊抢救室患者护理难度评价指标体系,具有一定的临床适用性,下一步将进行实证检验,以期为临床护理提供实用的护理难度评估工具。Objective: To construct a set of nursing difficulty evaluation index system applicable to patients in the emergency rescue room of a tertiary hospital. Methods: Through semi-structured interviews and reference to relevant literature on nursing difficulty indicators at home and abroad, the evaluation indicators of nursing difficulty were initially formulated, and two rounds of correspondence were conducted with 20 experts using the Delphi method. Results: A nursing difficulty evaluation index system for patients in the emergency rescue room of a tertiary-level A hospital was constructed, which included four primary indicators (severity of illness, difficulty of nursing operation, demand for nursing resources, and cooperation of patients and their families) and 15 secondary indicators. Conclusion: This study constructed a nursing difficulty evaluation index system for patients in the emergency rescue room, which has certain clinical applicability, and will be empirically tested in the next step, with the aim of providing a practical nursing difficulty assessment tool for clinical care.
