Zomorodi Meg, Topley Darla, McAnaw Maire
Chapel Hill School of Nursing, University of North Carolina, Chapel Hill, NC 27599-7460, USA.
Crit Care Res Pract. 2012;2012:964547. doi: 10.1155/2012/964547. Epub 2012 Dec 20.
As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs), so it is now important to focus on improving the patient outcomes and recovery. To do this, ICU patients need to be assessed and started on an early mobility program, if stable. While the early mobilization of the ICU patients is not without risk, the current literature has demonstrated that patients can be safely and feasibly mobilized, even while requiring mechanical ventilation. These patients are at a high risk for muscle deconditioning due to limited mobility from numerous monitoring equipment and multiple medical conditions. Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test. The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay. This paper describes a pilot study to evaluate an early mobilization protocol to test the safety and feasibility for mechanically ventilated patients in a surgical trauma ICU in conjunction with the current unit standards.
随着技术和药物的改进与增加,重症监护病房(ICU)的生存率也在提高,因此现在关注改善患者预后和康复情况很重要。要做到这一点,如果患者情况稳定,就需要对ICU患者进行评估并启动早期活动计划。虽然ICU患者的早期活动并非没有风险,但目前的文献表明,即使患者需要机械通气,也可以安全、可行地进行活动。由于众多监测设备导致活动受限以及多种疾病状况,这些患者发生肌肉失健的风险很高。通常,危重症患者仅能得到护士帮助的移动;例如,被翻身、在床上被拉起,或被从床上转移到担架上进行检查。实施一项可供重症护理护士使用的早期活动方案对于取得积极的患者预后、将因入住ICU导致的功能衰退降至最低很重要。本文描述了一项试点研究,以评估一项早期活动方案,结合当前科室标准,测试其在外科创伤ICU中对机械通气患者的安全性和可行性。