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首页> 外文期刊>Southern African Journal of Critical Care >Early mobilisation practices of patients in intensive care units in Zimbabwean government hospitals - a cross-sectional study
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Early mobilisation practices of patients in intensive care units in Zimbabwean government hospitals - a cross-sectional study

机译：津巴布韦政府医院重症监护病房患者的早期动员实践-横断面研究

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BACKGROUND. Recent evidence shows that early mobilisation of patients in an intensive care unit (ICU) is feasible, safe and associated with improvement in patients' clinical outcomes. However, its successful implementation is dependent on several factors, which include ICU structure and organisational practices. OBJECTIVES. To evaluate the structure and organisational practices of Zimbabwean government hospital ICUs and to describe early mobilisation practices of adult patients in these units. METHODS. A cross-sectional survey was conducted in all government hospitals in Zimbabwe. Data collected included hospital and ICU structure, adult patient demographic data and mobilisation activities performed in the ICU during the 24 hours prior to the day of the survey. RESULTS. A total of five quaternary level hospitals were surveyed, with each hospital having one adult ICU. Four of the units were open-type ICUs. The majority of the units (n=3; 60%) reported that they had a permanent physiotherapist who covered their unit, but none of the physiotherapists worked solely in the ICU. The nurse-to-patient ratio across all units was 1:1. None of the units utilised a standardised sedation scoring system or a standardised outcome measure to assess patient mobility status. Only one ICU (20%) had a patient eligibility guideline for early mobilisation in place. Across the ICUs, 40 patients were surveyed. The median (interquartile range) age was 33 (23.3 - 38) years and 24 (60%) were mechanically ventilated. Indications for admission into the ICU included acute respiratory failure (n=12; 30%) and postoperative care (n=10; 25%). Mobilisation activities performed in the previous 24 hours included turning the patient in bed (n=39; 97.5%), sitting over the edge of the bed (n=10; 25%) and walking away from the bedside (n=2; 5%). The main reason listed for treatment performed in bed was patients being sedated and unresponsive (n=13; 32.5%). CONCLUSION. Out-of-bed mobilisation activities were low and influenced by patient unresponsiveness and sedation, staffing levels and lack of rehabilitation equipment in ICU.
机译：背景。最近的证据表明，在重症监护病房（ICU）早期动员患者是可行，安全的，并与患者临床结局的改善相关。但是，其成功实施取决于几个因素，包括ICU结构和组织实践。目标评估津巴布韦政府医院重症监护病房的结构和组织实践，并描述这些部门中成年患者的早期动员实践。方法。在津巴布韦的所有政府医院进行了横断面调查。收集的数据包括医院和ICU的结构，成年患者的人口统计学数据以及在调查日前24小时内在ICU中进行的动员活动。结果。总共对五家四级医院进行了调查，每家医院都有一个成人ICU。其中四个是开放式ICU。大多数单位（n = 3; 60％）报告说，他们有一个永久性的物理治疗师来覆盖他们的单位，但是没有一个物理治疗师仅在ICU工作。所有单位的护士与病人比例为1：1。没有单位使用标准化的镇静评分系统或标准化的结局指标来评估患者的活动状况。只有一个ICU（20％）具备就早动员的患者资格指南。在ICU中，对40名患者进行了调查。中位年龄（四分位间距）为33（23.3-38）岁，机械通气为24（60％）。进入ICU的适应症包括急性呼吸衰竭（n = 12; 30％）和术后护理（n = 10; 25％）。在过去24小时内进行的动员活动包括使患者转入床位（n = 39; 97.5％），坐在床边（n = 10; 25％）并离开床边（n = 2; 5 ％）。列出在床上进行治疗的主要原因是患者正在镇静且无反应（n = 13; 32.5％）。结论。病床外的动员活动较少，并受ICU患者无反应和镇静，人员配备水平以及缺乏康复设备的影响。

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