循证护理在ICU中的应用

循证护理为临床护理的发展提供了可靠的依据，推动了护理事业的发展。综述了重症监护病房实施循证护理的必要性、存在的问题和可行性。举例说明实施循证护理的具体步骤，并对目前构建循证护理模式的基础工作提出了建议。     

行动研究法在ICU患者肠内营养相关性腹泻护理中的应用

目的:探讨ICU患者肠内营养相关性腹泻护理中的问题,在行动中不断规范ICU护士预防和管理肠内营养相关性腹泻的护理实践。方法:采用便利抽样法,选取2019年10月—2020年6月在同济大学附属第十人民医院重症医学科行肠内营养治疗的367例ICU患者作为研究对象,根据时间分为3组：护理流程实践前129例（2019年10—1...     

需要层次理论在ICU患者家属护理中的应用

本文通过阅读大量文献,总结ICU患者家属的需求,从马斯洛需要层次理论的角度对家属的需求进行分析分类,并针对性地提出护理措施,目的是希望通过满足患者家属的需求,使其能理解、支持、配合医护人员对患者的救治工作,从而提高ICU的护理工作质量。1患者家属的需求     

循证护理在内科ICU健康教育中的应用

目的 以最佳证据为基础开展护理工作,提高内科ICU患者及家属对疾病的诊断、治疗及护理的依从性及满意度,避免医患纠纷的发生.方法 确定问题;检索有关文献;评价相关实证,制定并实施护理计划.结果 实施循证护理后,我科的健康教育质量及患者满意度上升(达100%),无患者投诉事件发生.结论 循证护理的开展提高了护理服务质量,促进了护理事业的发展.     

重症监护信息系统在ICU护理中的应用分析

目的研究探讨重症监护信息系统在重症监护病房(intensive care unit,ICU)护理中的应用效果。方法随机选择我院ICU 2018年1～6月、2018年7～12月收治的重症患者各40例进行回顾性研究,分别设置为对照组、观察组,对照组实施常规护理,观察组护理中应用重症监护信息系统,比较两组每日护理事件耗时、护理事件差错频率、ICU治疗时间、住院时间、舒适度评分、不良情绪评分、护理满意度。结果 (1)观察组每日病情记录、观察项维护、出入量维护、医嘱核对等护理事件耗时均较对照组缩短,其各项护理事件差错频率均较对照组降低(P0.05)。(2)观察组ICU治疗时间、住院时间均较对照组缩短(P0.05)。(3)护理后,观察组的舒适度评分较对照组更高,其不良情绪各评分均较对照组更低(P0.05)。(4)护理总满意率分别为95.00%(观察组)、80.00%(对照组),观察组较对照组更高(P0.05)。结论重症监护信息系统的应用有效提高了ICU护理效率和护理质量,减少了护理差错发生,有利于缩短患者治疗时长,提高其舒适度,减轻其不良情绪,使其更加满意。     

中医情志护理在综合ICU老年患者中的应用

目的探讨中医情志护理在综合ICU老年患者中的应用及效果。方法将2007年4月~2008年5月入住综合ICU的120例老年患者随机分为2组,对照组采用传统的治疗方法,试验组在传统的治疗方法上运用中医情志护理的说理疏导、释疑解惑、移情相制、顺情从欲对患者进行心理护理,对2组患者护理质量满意度及拒绝配合诊疗的发生率进行比较。结果试验组护理质量满意度高于对照组,试验组拒绝配合诊疗的次数低于对照组,差异有统计学意义（P〈0．01）。结论中医情志护理能够帮助ICU医护人员对老年患者实施心理护理。     

眼部护理循证标准在重症监护患者中的应用

目的探索降低眼部并发症的护理循证实践方案。方法 2011年5~7月,对ICU内意识障碍、行镇静治疗或使用机械通气超过2d的患者进行分阶段研究。根据澳大利亚乔安娜.布里格斯研究中心(Joanna Briggs Institute,JBI)的标准,首先进行重症监护患者眼部护理的基线质量审查,然后实施JBI眼部护理循证实践方案,并进行干预后的质量审查。结果实施眼部护理循证实践方案后,在JBI眼部护理质量审查的7条标准中,4条标准的完成率得到极大提高。干预后重症监护患者结膜充血、结膜暴露和角膜暴露的发生率均较基线阶段明显降低(P<0.05)。结论 JBI眼部护理循证标准应用于重症监护患者,能降低患者眼部并发症,但仍需不断完善。     

以家庭为中心的人文护理在ICU患者中的应用现状

家庭的支持在患者治疗与康复中起着重要作用,家庭成员参与人文护理有助于减少并发症,改善患者的生活质量。本文分析了重症监护病房（ICU）患者及家属人文关怀需求,重点阐述了家庭成员参与的人文护理措施,旨在为进一步促进ICU人文护理发展提供参考和依据。     

早期预警评分在ICU护理工作中的应用

20世纪90年代初,为了加快病房潜在急危重症患者的鉴别,尽早进行高效合理的治疗干预,英国风险应急小组建立了早期预警评分(early warning score,EWS)[1]和改良早期预警评分(modified early warning score,MEWS)[2].该方法获取参数快速简单,对患者的预后预测评估准确性高,受到国内外医学界的广泛认可,是对危重病患者病情评估的一种简便、实用的评分系统[3-4].危重疾病评分是用数字化定量评价危重疾病的严重程度和预测预后的方法.在ICU及时收集患者病情发展变化的大量信息,制订能真实反映患者病情严重程度的评估系统具有重要意义.现就EWS评分在ICU护理工作中的应用现状及意义加以综述,以期使危重病评分系统在护理工作中得到更合理的运用,提高危重患者的护理质量.     

SLEEP-MAD模式改善ICU患者睡眠障碍的应用效果分析

目的探讨改善ICU患者睡眠质量的标准化结构方法SLEEP-MAD模式护理策略的效果。方法采用便利抽样法,将2018年7月1日—2019年6月30日入住山西白求恩医院山西医学科学院ICU的睡眠障碍患者共180例纳入研究,其中对照组为2018年7月1日—12月31日入住ICU的患者(85例)。观察组为2019年1月1日—6月30日入住ICU的患者(95例)。对照组给予常规的睡眠管理,观察组按照SLEEP-MAD模式要求进行集束化干预管理,采用中文版理查兹—坎贝尔睡眠量表(RCSQ)进行睡眠质量的评估及相关因素的资料收集,通过统计结果对应用效果进行分析说明。结果干预前,两组患者RCSQ各维度得分比较,差异无统计学意义(P>0.05);干预后,观察组患者各维度得分均高于对照组,除再入睡维度外,其余维度两组得分比较差异有统计学意义(P<0.05)。结论睡眠质量的标准化结构方法SLEEP-MAD模式应用于ICU睡眠障碍患者的护理,可以有效地提高患者的应对水平,提高和改善睡眠质量。     

重症监护室护理记录单的优化设计与应用

目的 设计ICU护理记录单,并研究其在提高护士工作效率中的作用。 方法 根据科室实际情况优化设计了文字、表格书写相结合的记录单,并与原ICU记录单比较。 结果 优化前、后的护理记录单记录字数和记录用时均少于优化前的护理记录单。 结论 优化后的护理记录单显著提高了书写质量和护理工作效率。     

ICU病人亲属家庭需要的调查研究

应用Molter“急危重病人家庭需要量表”对 5 0例ICU病人亲属进行调查 ,以了解当病人在ICU接受监护时 ,其亲属对病人家庭需要的认识。结果显示ICU病人亲属认为能够保证病人的安全 ,了解病人的治疗与预后 ,了解病人护理的需要最重要 ,而与病人亲属身心相关的需求重要性得分则较低。某些需要在男女病人亲属之间存在显著性差异 ,部分需要与病人亲属的年龄、教育水平和家庭收入分别有显著相关。提示ICU护士必须正确认识病人家庭需要 ,并根据病人亲属的性别、年龄、教育水平和家庭收入等因素满足病人家庭需要 ,以帮助病人家庭应对病人病重时的危机状态 ,维持病人及亲属的身心健康     

Effectiveness of aromatherapy on anxiety and sleep quality among adult patients admitted into intensive care units: A systematic review

PurposeThis review aims to evaluate the effectiveness of aromatherapy on anxiety and sleep quality among adult patients admitted to an intensive care unit.Materials and MethodsA systematic search for published and unpublished studies across nine databases and sources were conducted. Randomised Controlled Trials and Controlled Clinical Trials, which assessed the effectiveness of aromatherapy on anxiety and sleep quality among intensive care unit patients, were included in this review. Only studies that used aromatherapy as a single intervention were included. Narrative synthesis was conducted across all outcomes due to high heterogeneity across studies.ResultsA total of 26 studies involving 2176 participants across six countries were included in this review. Most studies had an overall high risk of bias. Publication bias was detected in the studies. Findings have shown that aromatherapy may be effective in reducing anxiety based on the low GRADE certainty of evidence, and improving sleep quality based on the very low GRADE certainty of evidence. Inconsistencies in findings were also observed.ConclusionAromatherapy might be beneficial on anxiety and sleep quality among intensive care unit patients, however, the level of evidence is very low, based on the low quality of studies. Considerations can be made to incorporate aromatherapy into existing interventions that improve anxiety and sleep quality in the intensive care unit. Due to inconsistencies in findings, further research can be done to investigate and strengthen these evidence.Implication for clinical practiceThis review has demonstrated that aromatherapy may have benefits on anxiety and sleep quality. Despite uncertain evidence, aromatherapy may still be considered as a complementary or alternative option to improve anxiety and sleep quality among intensive care patients as it is relatively safe, cost-effective and easy to implement (Buckle, 2014). However, proper training by a professional clinical aromatherapist is needed to ensure there is screening of patients for suitability, proper technique for administering aromatherapy, safe handling of essential oils and monitoring for adverse events (Farrar & Farrar, 2020).     

重症监护病房患者镇痛镇静的研究进展

镇痛镇静治疗已经成为重症监护病房中综合治疗的重要组成部分,可以消除或减轻患者的疼痛及不适,控制焦虑、躁动和谵妄,减轻应激反应,改善患者睡眠、诱导遗忘,提高机械通气的协调性,减轻医疗护理操作对患者造成的伤害性刺激,使危重患者处于舒适和安全的理想水平。本文对重症监护病房患者镇痛镇静的研究进展进行综述。     

Incidence,risk factors,and cumulative risk of delirium among ICU patients: A case-control study

ObjectivesDelirium is a common acute cognitive impairment syndrome among intensive care unit (ICU) patients. This study was aimed to investigate the incidence, risk factors, and cumulative risk of delirium among ICU patients.MethodsA case-control study including clinical records of 452 patients were retrospectively analyzed. Delirium was assessed using the Confusion Assessment Method for the ICU and Richmond Agitation–Sedation Scale.ResultsWe found that 163 out of the 452 patients (36.1%) had delirium. Multivariate analysis showed that use of sedatives, length of ICU hospitalization, and physical restraint were independent risk factors for delirium. The additive effect of all three factors resulted to an odds ratio of 30.950.ConclusionThe incidence of delirium remained high. Thus, nurses shall strengthen the monitoring of delirium, regularly access the patient's level of calmness, and limit the use of physical restraint.     

万古霉素治疗重症监护病房革兰阳性菌感染的研究进展

革兰阳性菌是ICU最为重要的致病菌之一,万古霉素作为一线用药对其感染疗效肯定。近期指南推荐的万古霉素血药浓度在临床应用较为广泛,但临床医师对增高的谷浓度所面临的不良反应(主要为肾功能损害)仍十分关注。现就万古霉素及其在急、危重症患者等特殊群体中药代/药效动力学,治疗方案的调整和相关肾损伤等方面予以综述。     

Person-centred care among intensive care unit nurses: A cross-sectional study

ObjectivePractising person-centred care is crucial for nurses in the intensive care unit, as patients have high physical and psychological care needs. We aimed to identify the predictors of person-centred care among nurses working in intensive care settings.MethodsIn this cross-sectional study, 188 intensive care unit nurses at four tertiary hospitals in two cities of South Korea were included. They completed self-reported questionnaires on emotional intelligence, compassion satisfaction, secondary traumatic stress, burnout, and person-centred care. Emotional intelligence was measured using the Korean version of the Wong and Law’s emotional intelligence scale. Compassion satisfaction, secondary traumatic stress, and burnout were measured by the Professional Quality of Life questionnaire (version 5). Person-centred care was measured using the person-centred critical care nursing scale.ResultsMultiple regression identified compassion satisfaction (β = 0.49, p <.001) as the most powerful predictor of person-centred care, followed by emotional intelligence (β = 0.21, p =.004) and intensive care unit career length (β = 0.17, p =.021). These three variables accounted for 31.0 % of the variance in person-centred care.ConclusionsThis study highlights the importance of career length, emotional intelligence, and compassion satisfaction in the promotion of person-centred care among intensive care unit nurses. Nursing management should contemplate specific measures to reduce turnover among experienced intensive care unit nurses and to enhance the factors that promote person-centred care, such as compassion satisfaction and emotional intelligence.     

ICU非机械通气患者口腔护理研究现状

ICU由于其特殊的抢救性质,容易使口腔护理被忽视或存在护理不足的现象,尤其是对于非机械通气患者,从而给医院和患者带来极大的影响.文章主要从ICU非机械通气患者发生非机械通气相关医院获得性肺炎(non-ventilator associated hospital-acquired pneumonia,NV-HAP)的概况...