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确定儿科重症监护患者经气管内吸引的标准:一项探索性研究。

Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: an exploratory study.

机构信息

Paediatric Intensive Care Unit, Princess Margaret Hospital, Roberts Road, Subiaco, Western Australia, 6008, Australia.

出版信息

Intensive Crit Care Nurs. 2011 Apr;27(2):85-93. doi: 10.1016/j.iccn.2011.01.002. Epub 2011 Mar 2.

Abstract

This four-phase mixed method study developed an evidence based "Endotracheal Suction Assessment Tool" (ESAT) as a guide for nurses undertaking "endotracheal tube" (ETT) suction within "Paediatric Intensive Care" (PIC). Phase 1 involved a comprehensive literature review to determine the most commonly used criteria for assessing the need for ETT suction. In Phase 2 an "Endotracheal Suction Questionnaire" (ESQ) was developed to survey experienced PIC nurses in Australia and New Zealand regarding their ETT suction decision making process and validity testing of the ESQ. In Phase 3, the ESQ was administered to target group (n=104). In Phase 4, the empirical evidence generated from this study, based upon the criteria rated by nurses in this study as being most clinically important and essential during the decision making process, determined the ESAT design. Analyses of quantitative results showed a positive correlation between the perceived frequency of use of a criterion and the appropriateness of the assessment. Where a criterion was used less frequently as a clinical indicator for the requirement for ETT suction, participants had a lower regard for this when rating the criterion as a specific single indicator to perform suction. Findings from qualitative data identified six criteria not previously documented within the literature. Further testing and validation of the tool within the PIC setting will determine the clinical viability of the ESAT.

摘要

这项四阶段混合方法研究开发了一种基于证据的“气管内吸引评估工具”(ESAT),作为护士在儿科重症监护(PIC)中进行“气管内管”(ETT)吸引的指南。第 1 阶段涉及全面的文献回顾,以确定评估 ETT 吸引需求最常用的标准。在第 2 阶段,开发了“气管内吸引问卷”(ESQ),以调查澳大利亚和新西兰经验丰富的 PIC 护士在 ETT 吸引决策过程中的情况,并对 ESQ 进行有效性测试。在第 3 阶段,ESQ 被用于目标人群(n=104)。在第 4 阶段,本研究产生的实证证据,基于本研究护士在决策过程中认为最具临床重要性和必要性的标准,确定了 ESAT 的设计。定量结果分析显示,护士认为标准的使用频率与评估的适宜性之间存在正相关。如果标准作为 ETT 吸引需求的临床指标使用频率较低,参与者在将该标准评为进行吸引的特定单一指标时,对该标准的重视程度就会降低。定性数据分析确定了以前文献中未记录的六个标准。在 PIC 环境中进一步测试和验证该工具将确定 ESAT 的临床可行性。

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