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开发一种用于机械通气患者撤机的准备情况评估工具。

Developing a readiness assessment tool for weaning patients under mechanical ventilation.

作者信息

Irajpour Alireza, Khodaee Mahnaz, Yazdannik Ahmadreza, Abbasi Saeed

机构信息

Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Critical Care Nursing, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Iran J Nurs Midwifery Res. 2014 May;19(3):273-8.

Abstract

BACKGROUND

Mechanical ventilation is one of the major supportive interventions in intensive care units. Weaning the patients from mechanical ventilation and its related criteria are of great importance due to the related complications. As there is no comprehensive standard to allocate the time of weaning and due to lack of local research in this field, development of a comprehensive tool to measure patients' readiness for weaning from mechanical ventilation is essential. Therefore, the present study was conducted with an aim to develop a readiness assessment tool for weaning patients from mechanical ventilation.

MATERIALS AND METHODS

This was a qualitative study with Delphi multi-triangulation design. In the first stage, the related items were extracted from the textbook and through searching the databases. In the second stage, after primary development of the items and based on supervisors' indications, a questionnaire was made and used for assessment through Delphi methods. Twenty individuals, meeting the inclusion criteria, were selected through purposive sampling and their viewpoints concerning acceptability of the items were collected. In the third stage, the items with appropriateness over 70% were selected, and in the fourth stage, the final questionnaire was developed after a session with a panel of experts and supervisors. In the present study, in the first stage, the needed items were collected from various articles and books to provide items extraction. In stages two to four, manual calculation and investigation made by a panel of experts and the research team were adopted.

RESULTS

In the first stage, 100 articles and 51 related books were selected. In the second stage, 87 items were extracted from the articles and books and were sent as semi-open questions of assessment. In the third stage, 28 items with consensus >70% were extracted, and in the fourth stage, 26 items were selected by a panel of experts and the finalized questionnaire with the title "Persian Weaning Tool" (PWT) was developed in three domains: Respiration with 9 items, cardiovascular with 4 items, and other related factors with 13 items.

CONCLUSIONS

A three-domain questionnaire is the product of experts' consensus in the present study, which can be used to reduce the length of connection to mechanical ventilation and its complications.

摘要

背景

机械通气是重症监护病房主要的支持性干预措施之一。由于相关并发症的存在,使患者脱离机械通气及其相关标准至关重要。由于目前尚无分配撤机时间的综合标准,且该领域缺乏本地研究,因此开发一种综合工具来评估患者从机械通气撤机的准备情况至关重要。因此,本研究旨在开发一种用于评估患者从机械通气撤机准备情况的评估工具。

材料与方法

这是一项采用德尔菲多重三角测量设计的定性研究。在第一阶段,从教科书和数据库搜索中提取相关条目。在第二阶段,在条目初步形成后,根据主管的指示制作问卷,并通过德尔菲法进行评估。通过目的抽样选择20名符合纳入标准的个体,并收集他们对条目的可接受性的观点。在第三阶段,选择适宜性超过70%的条目,在第四阶段,在与专家小组和主管进行一次会议后制定最终问卷。在本研究中,第一阶段从各种文章和书籍中收集所需条目以进行条目提取。在第二至四阶段,采用专家小组和研究团队进行的人工计算和调查。

结果

在第一阶段,选择了100篇文章和51本相关书籍。在第二阶段,从文章和书籍中提取了87个条目,并作为半开放式评估问题发送。在第三阶段,提取了26个共识率>70%的条目,在第四阶段,专家小组选择了26个条目,并最终形成了名为“波斯语撤机工具”(PWT)的问卷,该问卷分为三个领域:呼吸领域9项、心血管领域4项、其他相关因素领域13项。

结论

本研究中专家共识产生了一个三领域问卷,可用于缩短机械通气连接时间及其并发症。

相似文献

9
The art and science of predicting patient readiness for weaning from mechanical ventilation.
Int J Nurs Stud. 2000 Apr;37(2):145-51. doi: 10.1016/s0020-7489(99)00062-0.

本文引用的文献

8
When to wean from a ventilator: an evidence-based strategy.何时撤离呼吸机:基于证据的策略
Cleve Clin J Med. 2003 May;70(5):389, 392-3, 397 passim. doi: 10.3949/ccjm.70.5.389.

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