重症监护室可视化镇静镇痛评估工具的构建与应用

目的 开发重症监护室可视化镇静镇痛评估工具，探讨其在危重症患者镇静镇痛护理管理中的应用效果。方法 成立镇静镇痛护理管理小组，以智能移动设备为载体，形成基本信息评估、疼痛评估、镇静评估、谵妄评估及自动生成记录与提醒5大流程版块，从而实现镇静镇痛的可视化评估。2020年10月—12月正式在临床启用，与2019年同期镇静镇痛评估时长和及时率、评估流程准确率、结果正确率等指标进行比较。结果 应用可视化静镇痛评估工具后，护士评估患者镇静镇痛程度用时由(2.46±0.29)min缩短至(1.49±1.17)min，评估及时率由85.0%提高至94.0%，评估流程准确率由71.5%上升至99.0%，结果正确率由90.0%提高至95.5%。两组差异均有统计学意义(P<0.05)。结论 可视化镇静镇痛评估工具可以为ICU护理人员提供准确、客观的决策依据，能够减少评估用时，提高评估准确率及正确率，有助于提升ICU镇静镇痛护理质量。

Construction and application of a visual sedation and analgesia assessment tool in intensive care unit

Objective To develop a visual sedation and analgesia assessment tool in an intensive care unit(ICU)and investigate its role in critically ill patients.Methods A sedation and analgesia management team was established.Using intelligent mobile devices as the carrier,five process modules including basic information assessment,pain assessment,sedation assessment,delirium assessment,and automatic generation of records and reminders were formed,thus enabling visual assessment of sedation and analgesia.This tool was officially initiated in clinical practice in October 2020.Its performance during the period from October to December 2020 was compared with the same period in 2019 in terms of the assessment length and timeliness rate,the accuracy rate,and correctness rate.Results With the use of this visual tool,the length of sedation and analgesia assessments was reduced from(2.46±0.29)min to(1.49±1.17)min,the timeliness rate of the assessments increased from 85.0%to 94.0%,the accuracy rate increased from 71.5%to 99.0%,and the correctness rate increased from 90.0%to 95.5%.Differences were all statistically significant(P<0.05).Conclusions The visual sedation and analgesia assessment tool can offer ICU nurses with accurate and objective information for decision making,reduce the time spent on assessments,improve the accuracy and correctness of assessments,thus helping improve the quality of sedation and analgesia nursing in ICU.