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首页> 外文学位 >The use of an interdisciplinary paired sedation and spontaneous breathing protocol to reduce duration of mechnical ventilation and reduce length of stay in a medical intensive care unit.
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The use of an interdisciplinary paired sedation and spontaneous breathing protocol to reduce duration of mechnical ventilation and reduce length of stay in a medical intensive care unit.

机译：使用跨学科的配对镇静和自发呼吸方案来减少机械通气的持续时间并减少在重症监护病房的住院时间。

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摘要

Oversedation causes deleterious effects on patients that are mechanically ventilated in the intensive care unit and is linked to increased risk of hospital death and considerable economic burden to the patient and the hospital. The intention of this evidence-based project is to improve nurse's assessment and utilization of light sedation in the Medical Intensive Care Unit (MICU) which in turn would allow patients to proceed to a spontaneous breathing trial (SBT). Nurses and respiratory therapists (RT'S) in a MICU in a Medical Center were educated on a paired sedation and SBT protocol for mechanically ventilated patients. This protocol directed the nurses to use distinct sedation safety screening criteria to assess if their patients were a candidate for light sedation and follow the guidelines for sedation titration to achieve a Riker sedation agitation scale of 4. Subsequently, the RT's were trained to assess patients for SBT by using a specific SBT safety screen. Duration of mechanical ventilation and MICU length of stay was evaluated before and during the evidence based practice (EBP) project (sedation and SBT protocol). Statistical analysis revealed a decrease in duration of MV in the EBP group but the results were not statistically significant. MICU LOS was reduced in the EBP group which was statistically significant. Reeducating the staff with the use of the protocol during daily rounding at the bedside and providing quality tracking reports to the staff will improve adherence to the protocol and improve patient outcomes.;Keywords: sedation protocol, mechanical ventilation weaning protocol, sedation in critical care, prolonged MV, daily interruption of sedation, daily awakening, spontaneous breathing trial, and wake up and breath.
机译：过度用药会对在重症监护室进行机械通气的患者造成有害影响，并与增加的医院死亡风险以及给患者和医院带来巨大的经济负担相关。这个基于证据的项目旨在改善护士在重症监护病房（MICU）中对轻度镇静的评估和利用，从而使患者可以进行自发性呼吸试验（SBT）。对医疗中心的MICU中的护士和呼吸治疗师（RT'S）进行了针对机械通气患者的配对镇静和SBT规程培训。该规程指示护士使用不同的镇静安全性筛选标准来评估其患者是否适合进行轻度镇静，并遵循镇静滴定的指导方针，以达到Riker镇静搅拌等级4。随后，培训了RT来评估患者的镇静作用。通过使用特定的SBT安全屏幕进行SBT。在基于证据的实践（EBP）项目（镇静和SBT方案）之前和期间评估机械通气的持续时间和MICU住院时间。统计分析显示，EBP组MV持续时间减少，但结果无统计学意义。 EBP组MICU LOS降低，具有统计学意义。在床边每天四舍五入的过程中对工作人员进行使用规程的再培训，并向工作人员提供质量跟踪报告，这将提高对规程的依从性并改善患者的治疗效果。关键词：镇静方案，机械通气断奶方案，重症监护中的镇静，长时间的MV，每天镇静，每天唤醒，自然呼吸试验以及醒来和呼吸。

著录项

  • 作者

    Van Buitenen, Nancy.;

  • 作者单位

    Fairleigh Dickinson University.;

  • 授予单位 Fairleigh Dickinson University.;
  • 学科 Nursing.
  • 学位 D.N.P.
  • 年度 2016
  • 页码 107 p.
  • 总页数 107
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 生物形态学;
  • 关键词

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