Executive Member of the German DELIR Network, Friedrich-Ebert-Straße 60, 53177 Bonn, Germany.
Hospital Puerta Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain; Universidad Autónoma de Madrid, C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain.
Intensive Crit Care Nurs. 2018 Oct;48:52-60. doi: 10.1016/j.iccn.2018.01.008.
Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation. Where do the gaps exist in pain, agitation and delirium management, what are the barriers to guideline implementation and how can these problems be addressed to ensure patients receive optimised care? As an international professional consensus exercise, a panel of seven European intensive care nurses convened to discuss how to address these questions and establish how the provision of pain, agitation and delirium management can be improved in the intensive care unit.
近年来，我们对重症监护病房中疼痛、躁动和谵妄管理的理解有了显著的提高。国际指南和实施工具包变得更加基于证据、以患者为中心，并就危重病患者的最佳实践管理提供了明确的建议。然而，重症监护界强调了在疼痛、躁动和谵妄研究的几个领域需要更高阶的证据，并且研究表明，由于指南实施不足，相当数量的重症监护患者仍然接受过时的治疗。在疼痛、躁动和谵妄管理方面存在哪些差距，实施指南的障碍是什么，以及如何解决这些问题以确保患者获得最佳护理？作为一项国际专业共识活动，一个由七名欧洲重症监护护士组成的小组召开会议，讨论如何解决这些问题，并确定如何改善重症监护病房的疼痛、躁动和谵妄管理。
