ICU护士对集束化镇静镇痛策略的认知调查分析

目的了解蚌埠市5家二级甲等及以上综合性医院ICU护士集束化镇静镇痛策略认知、知识来源与需求。方法采用自行设计问卷对200名ICU护士进行调查。结果ICU护士集束化镇静镇痛策略知识得分为（4.87±0.97）分，认知水平较低的三项为疼痛管理、镇静评估工具和谵妄基础危险因素。不同ICU类型和ICU工作年限的护士问卷得分比较差异具有统计学意义（P < 0.05），两两比较结果显示，外科和综合科ICU护士得分均高于内科ICU护士（P < 0.05和P < 0.01），ICU工作年限为6~10年的ICU护士得分高于ICU工作年限为1~2年者（P < 0.05）。ICU护士获取集束化镇静镇痛策略知识的方式主要是科室讲座、学习班培训和自己查资料学习。ICU护士对早期活动的具体实施、镇静镇痛量表使用、谵妄评估与干预知识需求最大。结论蚌埠市5家二级甲等及以上综合性医院ICU护士集束化镇静镇痛策略知识水平较低，不能满足临床需要。可能与学校教育匮乏、临床继续教育和培训不足有关。建议在学校课程设置和临床培训中增加集束化镇静镇痛策略知识和技能的内容，提高ICU护士的专业水平，规范集束化镇静镇痛策略的临床操作，以改善ICU病人的临床结局。

Investigation and analysis of ICU nurses on the cognition of the cluster sedation and analgesia strategis

ObjectiveTo investigate the cognition, source of knowledge and demand of the cluster sedation and analgesia strategis (ABCDEF bundle) of the ICU nurses from 5 grade Ⅱ and above general hospitals.MethodsA total of 200 ICU nurses in Bengbu were investigated using self-designed questionnaire.ResultsThe score of nurses' knowledge of ABCDEF bundle was (4.87±0.97), and the cognitive levels of "pain management", "sedation and analgesic scale" and "risk factors of delirium" were lower.The differences of the scores of nurses in different ICUs and working years were statistically significant (P < 0.05).The results of pairwise comparison showed that the scores of nurses in surgical and general ICU were higher than that in internal medicine department (P < 0.05 and P < 0.01), and the score of nurses working in ICU for 6 to 10 years was higher than that in nurses working in ICU for 1 to 2 years (P < 0.05).The department lectures, class training and self-research were the main approaches of ICU nurses acquiring the knowledge of ABCDEF bundle.The implementation of early activities, use of sedative and analgesic scales, delirium assessment and intervention knowledge were the greatest needs of ICU nurses.ConclusionsThe knowledge level of ABCDEF bundle in ICU nurses from 5 grade Ⅱ and above general hospitals in Bengbu is low, which cannot meet with the clinical needs.It may be related to the lack of school education and clinical continuing education, and inadequate training.It is suggested to increase the knowledge and skills of ABCDEF bundle in school curriculum and clinical training, improve the professional level of ICU nurses, standardize the clinical operation of ABCDEF bundle, so as to improve the clinical outcome of ICU patients.