Lai Hsiu-Chuan, Chen Ya-Huei, Li Yi-Jene, Huang Hui-Mei, Tseng Chien-Hua, Chan Ming-Cheng
BSN, RN, Department of Nursing, Taichung Veteran General Hospital, Taiwan, ROC.
MSN, RN, Head Nurse, Department of Nursing, Taichung Veteran General Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2017 Dec;64(6):77-84. doi: 10.6224/JN.000085.
Patients with respiratory failure needing mechanical ventilation are common in the intensive care unit. These patients often require sedative and analgesic agents to alleviate their discomfort and to avoid causing associated safety issues. However, prolonged post-awakening confusion and changes in perception after withdrawal from sedatives and analgesic agents are common in daily practice. Thus, the optimal use of sedative and analgesic agents remains an important issue in the intensive care unit.
To optimize sedation by raising the rate of accuracy for administering analgesic and sedative agents in the intensive care unit from 30.44% to 60.88%.
We first analyzed the problem from the current situation of the daily practice and revised the protocol of using analgesic and sedative agents. In order to achieve an optimal outcome, the authors further arranged staff education and bedside training and established an audit system to check and improve protocol adherence.
The rate of accuracy for administering sedatives and analgesics improved from 34% to 93%.
With appropriately scaled protocols of sedatives and analgesics administration, intensive care nurses may easily target the consistent and optimal assessment and provide pain relief prior to sedation, which will improve the quality of sedation and patient safety.
需要机械通气的呼吸衰竭患者在重症监护病房很常见。这些患者通常需要使用镇静剂和镇痛剂来缓解不适并避免引发相关安全问题。然而，在日常实践中，停用镇静剂和镇痛剂后长时间的苏醒后谵妄以及感知变化很常见。因此，镇静剂和镇痛剂的最佳使用仍然是重症监护病房的一个重要问题。
将重症监护病房中镇痛剂和镇静剂给药的准确率从30.44%提高到60.88%，以优化镇静效果。
我们首先从日常实践现状分析问题，并修订了镇痛剂和镇静剂的使用方案。为了达到最佳效果，作者进一步安排了员工教育和床边培训，并建立了一个审核系统来检查和提高方案依从性。
镇静剂和镇痛剂的给药准确率从34%提高到了93%。
通过适当规范的镇静剂和镇痛剂给药方案，重症监护病房的护士可以轻松地进行一致且最佳的评估，并在镇静前缓解疼痛，这将提高镇静质量和患者安全性。
