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护士对心脏手术后患者血糖控制的认知

Nurses' perceptions of glycemic control in patients who have undergone cardiac surgery.

作者信息

Henry Linda, Dunning Elizabeth, Halpin Linda, Stanger Debra, Martin Lisa

机构信息

Cardiac Surgery Research, Inova Heart and Vascular Institute, Falls Church, Virginia 22042, USA.

出版信息

Clin Nurse Spec. 2008 Nov-Dec;22(6):271-7. doi: 10.1097/01.NUR.0000325381.92094.e0.

Abstract

BACKGROUND/SIGNIFICANCE: Previous work investigating the effect of glycemic control in patients who underwent cardiac surgery has demonstrated that obtaining and maintaining blood glucose values between 80 and 120 is imperative in achieving excellent clinical outcomes in a patient who have undergone cardiac surgery. However, the caregiver's workload associated with meeting this goal is only now beginning to be understood.

METHODS

This qualitative study used focus groups held on 3 consecutive days to interview nurses in the cardiovascular intensive care unit and cardiovascular step-down unit about their thoughts on glycemic control.Three research questions were developed to help guide the focus group discussions.

RESULTS

Ten nurses, 3 from cardiovascular intensive care unit and 7 from cardiovascular step-down unit, participated in the focus groups and saturation was accomplished. The essence of the nurses' message was that they recognize glycemic control as a very important part of their patient care. However, to be able to perform this intervention, they need available equipment, a designated person to obtain all blood glucose values, periodic updates on patient outcomes related to glycemic control, and a less intrusive way to draw the patients' blood.

CONCLUSION

The ability of the nurses to obtain glycemic control is hindered by the lack of time, lack of necessary resources/equipment, lack of knowledge about the long-term outcomes resulting from glycemic control, and the discomfort to patients caused by the frequent blood draws. Hospitals need to investigate alternative mechanisms that will assist the nurse in meeting this goal.

摘要

背景/意义:先前关于心脏手术患者血糖控制效果的研究表明,对于接受心脏手术的患者,将血糖值维持在80至120之间对于取得良好的临床结果至关重要。然而,与实现这一目标相关的护理人员工作量直到现在才开始被理解。

方法

这项定性研究连续三天举行焦点小组,就心血管重症监护病房和心血管降级病房的护士对血糖控制的看法进行访谈。提出了三个研究问题以帮助指导焦点小组讨论。

结果

十名护士参与了焦点小组,其中3名来自心血管重症监护病房,7名来自心血管降级病房,达到了饱和状态。护士传达的核心信息是,他们认识到血糖控制是患者护理中非常重要的一部分。然而,为了能够实施这项干预措施,他们需要可用的设备、指定专人获取所有血糖值、定期更新与血糖控制相关的患者结果,以及采用侵入性较小的方式采集患者血液。

结论

护士进行血糖控制的能力受到以下因素的阻碍:时间不足、缺乏必要的资源/设备、对血糖控制的长期结果缺乏了解,以及频繁采血给患者带来的不适。医院需要研究能够帮助护士实现这一目标的替代机制。

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