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重症监护中早期活动的障碍与促进因素:一项定性研究。

Barriers and facilitators to early mobilisation in Intensive Care: a qualitative study.

作者信息

Barber Elizabeth A, Everard Tori, Holland Anne E, Tipping Claire, Bradley Scott J, Hodgson Carol L

机构信息

The Alfred, Australia.

Australian and New Zealand Intensive Care Research Centre, Monash University, Australia; The Alfred, Australia.

出版信息

Aust Crit Care. 2015 Nov;28(4):177-82; quiz 183. doi: 10.1016/j.aucc.2014.11.001. Epub 2014 Dec 19.

Abstract

OBJECTIVES

To determine the barriers and facilitators of early mobilisation in the Intensive Care Unit.

BACKGROUND

It is well established that mobilising critically ill patients has many benefits, however it is not occurring as frequently as expected. The causes and ways to change this are not clearly understood.

METHODS

A qualitative descriptive study involving focus groups with medical, nursing and physiotherapy clinicians, from an Australian quaternary hospital Intensive Care Unit.

RESULTS

The major themes related to barriers included the culture of the Intensive Care Unit; communication; and a lack of resources. Major themes associated with facilitating early mobilisation included organisational change; improved communication between medical units; and improved resources.

CONCLUSIONS

Early mobilisation was considered an important aspect of critically ill patient's care by all clinicians. Several major barriers to mobilisation were identified, which included unit culture, lack of resources, prioritisation and leadership. A dedicated mobility team led by physiotherapists in the ICU setting could be a viable option to address the identified barriers related to mobility.

摘要

目的

确定重症监护病房早期活动的障碍和促进因素。

背景

众所周知,让重症患者活动有诸多益处,但实际发生的频率并未达到预期。其原因及改变这种情况的方法尚不清楚。

方法

一项定性描述性研究,涉及澳大利亚一家四级医院重症监护病房的医学、护理和物理治疗临床医生焦点小组。

结果

与障碍相关的主要主题包括重症监护病房的文化;沟通;以及资源匮乏。与促进早期活动相关的主要主题包括组织变革;医疗单位之间沟通的改善;以及资源的改善。

结论

所有临床医生都认为早期活动是重症患者护理的一个重要方面。确定了几个主要的活动障碍,包括科室文化、资源匮乏、优先级和领导力。由物理治疗师在重症监护病房环境中领导的专门活动团队可能是解决已确定的与活动相关障碍的可行选择。

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