Rose Louise, Redl Leanne
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Room 276, Toronto, ON M5T1P8, Canada.
Intensive Crit Care Nurs. 2008 Dec;24(6):359-65. doi: 10.1016/j.iccn.2008.05.002. Epub 2008 Jul 1.
To describe the minimal occlusive volume (MOV) procedure used to monitor cuff inflation and identify practice variation.
Self-administered questionnaire.
Adult intensive care unit in an Australian university-affiliated hospital.
Survey response was 71% (80/113). Three methods of MOV were identified. Full cuff deflation, followed by reinflation, removal of 1mL increments of air until a leak was detected, then restoration of cuff seal with 1mL of air was the preferred method (47/80 respondents, 59%) (Method 1). Full cuff deflation followed by incremental addition of air until the MOV was established was used by 25/80 (31%) respondents (Method 2). Two (2.5%) nurses established MOV without full cuff deflation (Method 3), five (6.25%) used more than one method and one (1.25%) nurse did not perform cuff checks. Practice variation was identified for patient positioning, confirmation of cuff seal, and cuff leak management. Consistency of practice was noted in MOV procedure frequency, the number of nurses required, pre-oxygenation and oropharyngeal suctioning prior to cuff deflation.
Substantial practice variation for certain aspects of cuff management was noted. Evidence to support the efficacy of MOV procedural elements is required to limit practice variation and reduce risk to patients.
描述用于监测袖带充气并识别操作差异的最小闭合容量（MOV）程序。
自行填写问卷。
澳大利亚一所大学附属医院的成人重症监护病房。
调查回复率为71%（80/113）。确定了三种MOV方法。首选方法是先将袖带完全放气，然后重新充气，每次抽出1毫升空气，直到检测到漏气，然后再注入1毫升空气恢复袖带密封（47/80名受访者，59%）（方法1）。25/80（31%）的受访者采用先将袖带完全放气，然后逐渐充气直至确定MOV的方法（方法2）。两名（2.5%）护士在未完全放气袖带的情况下确定了MOV（方法3），五名（6.25%）使用了不止一种方法，一名（1.25%）护士未进行袖带检查。在患者体位、袖带密封确认和袖带漏气处理方面发现了操作差异。在MOV程序频率、所需护士人数、袖带放气前的预给氧和口咽吸引方面，操作具有一致性。
注意到袖带管理某些方面存在显著的操作差异。需要有证据支持MOV程序要素的有效性，以限制操作差异并降低患者风险。
