监护室护士机械通气相关知识认知现状的调查与对策

机械通气系治疗多种原因引起呼吸衰竭的有效手段，其可改善机体的通气和（或）氧合功能，有利于呼吸功能的改善和维持，对于临床护士而言，正确掌握机械通气的相关知识、及时处理机械通气时的各项报警和做好机械通气病人的护理，对减少机械通气相关的并发症、缩短带机时间、提高抢救和脱机成功率至关重要。为提高本院ICU护士对机械通气病人护理的质量，近期对监护室护士进行机械通气相关知识认知情况的调查，为制定相关的培训计划提供依据。现介绍如下。     

上海市三级甲等医院重症监护室护士机械通气镇静知识的调查

[目的]了解上海市三级甲等综合性医院重症监护病房(ICU)护士对机械通气镇静知识掌握程度及其影响因素。[方法]按监护室工作年限进行分层抽样,在14所上海市三级甲等综合性医院中抽取ICU护士133名,采用ICU护士机械通气镇静知识掌握程度问卷进行调查。[结果]ICU护士机械通气镇静知识总分为10.74分±1.94分,镇静知识掌握程度与是否接受过镇静知识培训有关。[结论]护士对镇静知识掌握现状不容乐观,应对ICU护士开展机械通气相关知识培训并制定规范的操作流程及护理方案,以保证镇静治疗的良好疗效。     

手术室护士对艾滋病相关知识的认知现状调查

艾滋病自1981年发生首例以来,迅速在全球范围内蔓延.我国艾滋病感染者和患者约有70万[1],并且有从特殊人群向普通人群扩散的趋势[2],患者在医院内的分布相对更为隐匿、更为广泛.而手术室医务人员针刺伤发生率和血(体)液飞溅在破损皮肤的比例高,面临着比医院内其他岗位的工作人员更高的职业暴露危险.     

外科护士包虫病相关知识认知调查

包虫病是一种严重危害人类健康和畜牧业发展的人畜共患寄生虫病[1],在我国分布广泛,新疆是包虫病高发区[2]。护士对包虫病相关知识的认知状况直接决定包虫病病人的护理质量。为此,本研究拟通过问卷调查了解外科护士对包虫病相关知识的认知现状,并探讨如何提高护士对包虫病相关知识的掌握,为     

护士对疼痛相关知识的认知现状

目的:调查与疼痛相关的科室护士对疼痛知识的掌握情况,分析影响因素,为疼痛知识培训与管理提供参考。方法:采用疼痛知识问卷调查法,对山西省某三甲医院相关科室护士进行疼痛知识问卷调查。经文献回顾、结合护士日常工作中需掌握的疼痛基本知识自行设计,经本院疼痛护理委员会专家评议,进行预调查,修改问卷最终确定问卷题目,调查符合纳入标...     

低年资护士对静脉输液治疗相关知识认知现状调查及对策

目的了解低年资护士对静脉输液治疗相关知识的认知现状。方法采用《静脉输液治疗相关知识调查表》,选取低年资护士200名为调查对象进行问卷调查。结果 80%的低年资护士静脉输液治疗知识主要来源于医院培训;低年资护士对静脉输液治疗操作知识、静脉导管的维护知识及静脉治疗相关并发症处理原则掌握情况认识不够全面。结论低年资护士对静脉输液治疗相关知识的认识掌握欠全面性、系统性和专业性,护理管理者应重视低年资护士静脉输液治疗相关知识的培训,促进静脉输液治疗规范化和专业化,有效保障护理质量和安全,以确保患者安全。     

对新上岗护士压疮相关知识的认知现状调查

目的：了解新上岗护士对压疮相关知识的认知状况。方法：采取自行设计的调查问卷,对176名新上岗各学历护士进行压疮有关知识的问卷调查。结果：新上岗各学历护士对压疮的相关知识均贫乏。结论：建议各医学院校改革基础护理教材,增加临床实践。     

综合医院护士肺结核防护知识认知现状调查

[目的]了解三级甲等综合医院护士肺结核防护知识现状。[方法]采用肺结核防护知识问卷对衡阳市某三级甲等综合性医院153名护士进行调查,分析护士肺结核防护知识水平及其影响因素。[结果]153名护士肺结核防护知识总得分为(17.74±2.69)分,答对率为69.84%;传播途径得分最高(5.27分±1.06分),药物控制得分最低(3.46分±1.05分);高职称、高职务、高学历、护龄长和参加系统全面的肺结核防护知识培训的护士得分较高。[结论]综合医院护士肺结核防护知识处于中等水平,医院应加强对低年资、低学历护士肺结核防护知识的培训。     

呼吸重症监护室内机械通气相关性肺炎护理对策分析

目的:探究呼吸重症监护室内机械通气相关性肺炎护理对策的治疗效果.方法:筛选出的80例机械通气相关性肺炎患者均是在2019年1月到2021年1月期间接收的,按照随机的方法分为两组,每组各为40例,其中对照组依然和以往实施的常规护理一样,观察组增加一些护理干预手段,对比分析两组患者的机械通气时间、住院时间、护理质量及护理满...     

A multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation

BACKGROUND: Nursing-directed sedation protocols have been shown to reduce the duration of mechanical ventilation and shorten the length of intensive care unit (ICU) stay among critically ill adult patients. METHODS: We designed a self-administered questionnaire to understand nurses' satisfaction with current sedation and analgesia practices as well as drug therapies in the ICU setting and the perceived relevance of sedation protocols to patient care and nursing autonomy. We surveyed nurses from 3 academic medical-surgical ICUs that were not using a sedation protocol or a sedation scale. Responses were based on a 5-point Likert scale and on text responses to open-ended questions. RESULTS: Of the 88 respondents, only 52.7% were satisfied (score, > or =4) overall with their local ICU's approach to sedation and analgesia. Nurses favored the use of morphine (85.0%), midazolam (71.2%), and fentanyl (59.6%) over that of lorazepam (38.6%) and haloperidol (15.4%). Some nurses (39.3%) were satisfied with the subjective methods used in their ICU to evaluate sedation adequacy. Almost all respondents believed that a nursing-directed sedation protocol combined with a sedation/agitation scoring system would be valuable to patient care (84.3%) as well as professional nursing practice (85.3%) and that a standardized approach by nurses and physicians was important (81.6%). CONCLUSIONS: In this survey of ICU nurses, we identified a perceived need for improvement in sedation and analgesia practices. Most respondents believed that the use of a nursing-directed sedation protocol in combination with a sedation scoring system would provide greater practice consistency among nurses and physicians and thus improve the care of critically ill patients.     

ICU机械通气患者肺复张术的临床应用

目的探讨肺复张术对机械通气患者血压、血氧饱和度(SaO2)的影响及临床效果。方法选择2008年2月至2009年8月38例实施肺复张术患者,分析其复张效果、肺复张术的不良反应等。肺复张采取固定驱动压、逐渐增加呼气末正压(PEEP)的方法,所有肺复张患者均进行有创动脉血压监测。结果 38例患者进行了162次肺复张术,其中2例慢性阻塞性肺病急性加重(AECOPD)患者发生气胸,肺复张总有效率90%。肺复张中有效PEEP变化较大,最低6 cm H2O(1 cm H2O=0.098 kPa),最高30 cm H2O;SaO2维持最短0.5 h,最长126 h;平均每例患者接受4.26次,其中有1例患者最多接受8次肺复张术。18例(47%)患者在肺复张中曾经发生过低氧血症,162次肺复张术中发生72次(44%)低氧血症;开始诱发低氧血症的最低PEEP为6 cm H2O,最高为20 cm H2O,平均13.0 cm H2O。21例(55%)患者肺复张中曾发生过血压短暂降低,162次肺复张中有68次(41%)血压短暂降低;开始出现血压下降的最低PEEP为6 cm H2O,最高为21cm H2O,平均13.5 cm H2O。结论肺复张术可以有效改善SaO2,PEEP的设定应遵循个体化的原则。     

重症监护病房专科护士培训面临的困境与对策

临床实践教学质量是决定专科护理人才培养质量的关键。由于医院职能向服务型转变，相关法规的制定以及临床实践教学效果评价体系的缺乏，对临床实践教学构成影响与冲击。通过完善临床实践教学法规建设、创新教学内容、加强教学质量控制、拓展教学空间等对策，切实提高重症监护病房（ICU）专科护士临床实践的教学质量。     

重症监护病房专科护士培训面临的困境与对策

临床实践教学质量是决定专科护理人才培养质量的关键。由于医院职能向服务型转变,相关法规的制定以及临床实践教学效果评价体系的缺乏,对临床实践教学构成影响与冲击。通过完善临床实践教学法规建设、创新教学内容、加强教学质量控制、拓展教学空间等对策,切实提高重症监护病房(ICU)专科护士临床实践的教学质量。     

综合ICU机械通气患者气道感染监测结果分析与对策

目的分析综合ICU有刨机械通气患者气道病原菌分布规律,提出解决及预防气道感染发生的对策。方法采用前瞻性研究与回顾性调查相结合的方法,对入住综合ICU的25例有创机械通气患者的气道进行感染监测,并对其临床资料进行分析。结果呼吸机相关性肺炎发生率为64．00％;下呼吸道与呼吸机管路存在多重菌感染,二者病原菌一致;呼吸机管路的污染率随通气时间延长而升高。结论加强气道管理与感染监控,缩短呼吸机管道更换周期,是预防呼吸机相关性肺炎的重要措施。     

Decisions made by critical care nurses during mechanical ventilation and weaning in an Australian intensive care unit.

BACKGROUND: Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. OBJECTIVE: To characterize the role of Australian critical care nurses in the management of mechanical ventilation. METHODS: A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. RESULTS: Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. CONCLUSIONS: In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.     

Stresses and coping strategies of neonatal intensive care unit nurses

The purposes of this study were to investigate the nature of the psychological stresses experienced by neonatal intensive care unit nurses and to describe the coping strategies they reported using to alleviate them. Sixty nurses from eight hospitals participated. Ten categories of stressful experiences were identified. A coping scale using short-story problem situations as stimuli was constructed. Factor analysis of the mean ratings of 13 coping strategies produced three factors: Cognitive Processing, Using Personal Skills, and Escape. Analysis of variance using these ratings and stress levels of the stories showed a significant main effect for stress level and a significant interaction between coping factors and stress levels. No significant differences in coping strategies were found by hospital or by the nurse variables of tenure (length of time) in the unit, education, or experience.     

对护士隐性护理知识认知状况调查

随着医学的发展和护理模式的转变，护理工作的内涵得到了不断丰富和发展，现代护理概念也赋予了护士更高层次的知识要求。根据获取和传递护理知识的难易程度，可将其划分为显性和隐性护理知识。前者能够使用护理期刊杂志、护理教学软件和护理操作规程等有形载体将其记录下来，通过语言、文字、数字、图表等形式进行沟通和共享；后者是隐含在护理人员个体内在的，不能或难于编码和度量的护理知识。护理服务工作中，隐性护理知识占临床护理知识的绝大部分，加强隐性护理知识的开发与利用对于满足现代护理质量，满足护理职业需要，建立和谐护患关系，提高整体护理人员的专业素养，创建自己独立的护理品牌，提高医院综合竞争力都具有重要的意义。我们通过问卷方式对我院护士进行隐性护理知识认知调查，以了解护士对隐性护理知识的认识状况，探讨如何充分发挥隐性护理知识在现代护理学中的应用。