重症监护病房中的谵妄评估：土耳其护士的实践与认知
Delirium assessment in intensive care units: practices and perceptions of Turkish nurses.
作者信息
Özsaban Aysel, Acaroglu Rengin
机构信息
Istanbul University Florence Nightingale Nursing Faculty, Department of Fundamentals of Nursing, Istanbul, Turkey.
出版信息
Nurs Crit Care. 2016 Sep;21(5):271-8. doi: 10.1111/nicc.12127. Epub 2015 Jan 28.
BACKGROUND
As delirium in intensive care unit (ICU) patients is a serious problem that can result in increased mortality and morbidity, routine delirium assessment of all ICU patients is recommended. The severity, duration and outcome of the syndrome are directly related to nurses' continuous assessment of patients for signs and symptoms of delirium. However, studies indicate that very few nurses monitor for delirium as a part of their daily practices.
AIM
The aim of this study was to identify current practices and perceptions of intensive care nurses regarding delirium assessment and to examine the factors that affect these practices and perceptions.
DESIGN
A descriptive, correlational study design was used.
METHODS
Data were collected from five Turkish public hospitals using a structured survey questionnaire. The study sample comprised 301 nurses who agreed to participate. Data were analysed using descriptive statistics.
RESULTS
More than half of the nurses performed delirium assessments. However, the proportion of nurses who use delirium assessment tools was quite low. Almost all of the nurses perceived delirium as a problem and serious problem for ICU patients. The patient group least monitored for delirium was that of unconscious patients. Statistically significant differences were found in the proportion of nurses who assessed delirium symptoms and whose care delivery system was patient-centred and perceived delirium as a serious problem.
CONCLUSION
While a majority of ICU nurses perceived delirium as a problem and serious problem, the proportion of those who perform routine delirium assessments was less. It was found that delirium assessment practices of nurses were affected from their perceptions of delirium and the implementation of patient-centred care delivery.
RELEVANCE TO CLINICAL PRACTICE
It is essential to develop strategies to encourage ICU nurses to perform delirium assessments through the use of delirium assessment tools.
背景
由于重症监护病房（ICU）患者的谵妄是一个严重问题，可导致死亡率和发病率上升，因此建议对所有ICU患者进行常规谵妄评估。该综合征的严重程度、持续时间和结果与护士对患者谵妄体征和症状的持续评估直接相关。然而，研究表明，很少有护士在日常工作中监测谵妄。
目的
本研究的目的是确定重症监护护士目前在谵妄评估方面的做法和看法，并检查影响这些做法和看法的因素。
设计
采用描述性、相关性研究设计。
方法
使用结构化调查问卷从五家土耳其公立医院收集数据。研究样本包括301名同意参与的护士。使用描述性统计分析数据。
结果
超过一半的护士进行了谵妄评估。然而，使用谵妄评估工具的护士比例相当低。几乎所有护士都认为谵妄是ICU患者的一个问题和严重问题。谵妄监测最少的患者群体是昏迷患者。在评估谵妄症状、护理提供系统以患者为中心且认为谵妄是严重问题的护士比例方面存在统计学显著差异。
结论
虽然大多数ICU护士认为谵妄是一个问题和严重问题，但进行常规谵妄评估的护士比例较低。发现护士的谵妄评估做法受到他们对谵妄的看法以及以患者为中心的护理实施的影响。
与临床实践的相关性
制定策略鼓励ICU护士通过使用谵妄评估工具进行谵妄评估至关重要。
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