Department of Intensive Care Nursing, Lovisenberg Deaconal College, Oslo, Norway.
Intensive Crit Care Nurs. 2010 Oct;26(5):270-7. doi: 10.1016/j.iccn.2010.06.006. Epub 2010 Aug 14.
To describe intensive care nurses' perceptions of unit and personal sedation practice in the context of nursing and medical treatment of adult intensive care patients sedated and ventilated for more than 24 hours.
Self-administered questionnaire.
Three general ICUs in three university hospitals in Norway.
Eighty-six questionnaires were returned (response rate 47%). Continuous infusions of fentanyl and midazolam were perceived as most common and nurses often gave both analgesics and sedatives prior to care. Daily interruption of sedation or analgesia-based sedation was not perceived as practice in the units. MAAS was most commonly used, whilst protocols or objective scoring systems were not. Documentation of sedation levels was fairly routine, whereas documentation of patient needs was not perceived as important. Collaboration with physicians was viewed as most important, whilst no significance was assigned to collaboration with relatives.
The study shows that a focus on analgesia-based sedation and continual control of the sedation level should be considered in order to decrease the risk of oversedation. Inclusion of relatives' opinions, increased collaboration between nurses and physicians, and implementation of sedation tools, may contribute to even better patient outcome and should be focus in further studies.
描述重症监护病房护士在为接受镇静和通气超过 24 小时的成年重症监护患者进行护理和医疗的背景下，对科室和个人镇静实践的看法。
自我管理式问卷调查。
挪威三所大学医院的三个综合重症监护病房。
共收回 86 份问卷（应答率 47%）。芬太尼和咪达唑仑持续输注被认为是最常见的，护士在护理前经常同时给予镇痛剂和镇静剂。每日中断镇静或基于镇痛的镇静在科室中并未被视为常规做法。MAAS 是最常用的评估工具，而没有使用方案或客观评分系统。镇静水平的记录相当常规，但患者需求的记录则不被视为重要。与医生的合作被认为是最重要的，而与家属的合作则没有被赋予重要性。
研究表明，为了降低过度镇静的风险，应关注基于镇痛的镇静和持续控制镇静水平。纳入家属的意见、增加护士与医生之间的协作，以及实施镇静工具，可能有助于改善患者的预后，这应成为进一步研究的重点。
