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目的探讨早期活动对ICU机械通气患者谵妄发生的影响。方法将我院2016年10月-2017年4月ICU收治的137例机械通气患者随机分组并进行常规护理干预和早期活动干预,分别在入住ICU后第1天、第2天、第3天及停机械通气时对患者进行谵妄(CAM-ICU)评估、APACHEII评分,并记录患者ICU停留时间,分析早期活动对谵妄发生,病情改善及ICU停留时间的影响。结果与对照组相比,早期活动组在入院第3天后可以显著降低患者的ICU谵妄发生率、APACHEII评分,缩短患者ICU停留时间,差异有统计学意义(P0.05)。结论专业的早期活动可以降低ICU机械通气患者谵妄的发生率,改善患者病情。 相似文献
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ObjectivesThe aim of this study was to investigate high-priority training needs by analysing the perceived importance and self-reported performance of nurses’ delirium care competency.DesignA cross-sectional survey with a convenience sample of 255 Korean intensive care units nurses.SettingIntensive care units in the Republic of Korea.Main outcome measuresIntensive care unit nurses’ delirium care competency.ResultsExploratory factor analysis of the Nurse Delirium Care Competency Scale showed a six-factor structure, which accounted for 67.51% of the variance in nurses’ delirium care competency: management algorithm, prevention, communication, nursing management, assessment, and collaboration. The self-reported performance scores of all six factors were significantly lower than their perceived importance scores. The delirium assessment factor was identified as a high training priority on the importance-performance matrix for new graduate nurses.ConclusionTraining programmes should be developed considering the six delirium care competency factors identified in this study. Further, nurse educators must adopt active educational modalities such as case-based small group learning and simulation-based learning to improve nurse competency in recognising and managing delirium. 相似文献
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《Clinical toxicology (Philadelphia, Pa.)》2013,51(9):851-853
Context. Emergency medical workers often experience violence while performing their job functions. Phencyclidine (PCP)-intoxicated patients are often violent and difficult to control physically. A chemical restraint is frequently needed to assist in protecting both patients and staff from agitated persons. Objective. This study evaluated haloperidol as a chemical restraint in PCP-intoxicated patients. Methods. This is a retrospective case series of all PCP-positive patients who received haloperidol for behavioral control from April 2008 to April 2011 at a single large (944 bed), urban, tertiary-care hospital. All patients receiving haloperidol and having a toxicology screen positive for PCP were identified using an electronic medical record. Identified cases were then manually reviewed by investigators for adverse events. Results. Subjects included 59 adult patients who were acutely agitated requiring chemical restraint or sedation with haloperidol, and who tested positive for PCP. There were 20 females and 39 males, ranging in age from 19 to 54 years. Patients received haloperidol via the PO, IM, or IV routes in doses ranging from 1 to 10 mg. There were two adverse events (mild hypoxia and mild hypotension) found during chart review; neither were serious nor required change in patient disposition. Conclusions. In this study, haloperidol does not seem to cause harm when used in the management of PCP-intoxicated patients. Caution must always be exercised in the use of chemical restraint; further prospective study is warranted. 相似文献