C.-J. Cederwall, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Intensive care unit, Sahlgrenska University Hospital, CIVA, Gröna stråket 2, 413 45 Gothenburg, Sweden.
Nurs Crit Care. 2014 Sep;19(5):236-42. doi: 10.1111/nicc.12092. Epub 2014 May 9.
For most critically ill patients requiring mechanical ventilation in the intensive care unit (ICU) weaning is uncomplicated. For the remainder, weaning is a challenge and may result in further complications and increased risk of mortality. Critical care nurses (CCNs) require substantial knowledge and experience to manage patients experiencing prolonged weaning.
The aim of this study was to explore CCNs approach for management of patients experiencing prolonged weaning in the ICU.
A descriptive qualitative design.
Semi-structured interviews with 19 experienced CCNs were conducted. Data were analysed using content analysis.
Participants used various strategies for weaning that were grouped into four categories: individualized planning for the weaning process, assessing patient's capacity, managing the process and team interaction. The overall theme that emerged was: CCNs drive the weaning process using both a patient centred and targeted approach.
CCNs in these ICUs performed weaning using a patient centred approach to plan, initiate, assess and establish a holistic weaning process. Team collaboration among all health care practitioners was important. CCNs have a key role in prioritizing weaning and driving the process forward.
Closeness to the patient and a key role in management of the mechanical ventilated patient in ICU gives the CCN unique potential to develop and create models and tools for prolonged weaning. These tools, specially designed for patients undergoing prolonged weaning, would give focus on continuous planning, collaborating, managing and evaluation in the process of liberating patients from mechanical ventilation.
对于大多数在重症监护病房（ICU）需要机械通气的危重症患者，脱机过程通常较为顺利。但对于其余患者，脱机则颇具挑战性，可能导致进一步的并发症，并增加死亡率。重症监护护士（CCN）需要具备大量的知识和经验，才能管理经历长时间脱机的患者。
本研究旨在探讨 CCN 对 ICU 中经历长时间脱机的患者的管理方法。
描述性定性设计。
对 19 名经验丰富的 CCN 进行半结构式访谈。采用内容分析法对数据进行分析。
参与者采用了各种脱机策略，这些策略分为四个类别：个体化的脱机过程计划、评估患者能力、管理过程和团队互动。出现的总体主题是：CCN 使用以患者为中心和有针对性的方法来推动脱机过程。
这些 ICU 中的 CCN 使用以患者为中心的方法来计划、启动、评估和建立全面的脱机过程。所有医疗保健从业者之间的团队协作非常重要。CCN 在优先考虑脱机并推动该过程方面发挥着关键作用。
与患者的亲近程度以及在 ICU 中管理机械通气患者的关键角色，使 CCN 具有独特的潜力来开发和创建用于长时间脱机的模型和工具。这些专门为经历长时间脱机的患者设计的工具将专注于持续规划、协作、管理和评估使患者从机械通气中解放出来的过程。
