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重症监护病房护士对患者早期活动的知识、态度和感知障碍。

Intensive care unit nurses' knowledge, attitudes, and perceived barriers regarding early mobilization of patients.

机构信息

School of Nursing, Capital Medical University, Beijing, China.

Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China.

出版信息

Nurs Crit Care. 2020 Nov;25(6):339-345. doi: 10.1111/nicc.12507. Epub 2020 Apr 13.

Abstract

BACKGROUND

It has been recommended that critically ill patients start mobilization as early as possible. However, the clinical utilization rate of early mobilization remains low in the intensive care unit (ICU), and respiratory therapists and nurses are the primary practitioners of early mobilization in China.

AIM

The aim of this study is to investigate the knowledge, attitudes, and perceived barriers of ICU nurses regarding the early mobilization of ICU patients.

DESIGN

A descriptive and cross-sectional design was used.

METHODS

A cross-sectional design was used, with an e-questionnaire for ICU nurses (n = 227) to assess knowledge and attitudes regarding early mobilization via the "Tencent WeChat" app on their smart phones.

RESULTS

As the primary implementers of the early mobilization of ICU patients in China, more than half of ICU nurses passed the knowledge test (scored ≥20/25 points) and had positive attitudes (scored 45/55 points) regarding early mobilization. Nurses had good knowledge (more than 96.5%) of the benefits and stopping indications of early mobilization; however, they had a poor understanding (less than 51.1%) of the population in which early mobilization is applicable and monitoring indicators during early mobilization, and 39.2% of nurses did not support routine implementation of early mobilization for patients in the ICU. The major barriers that they perceived were very heavy workload (76.8%), insufficient equipment and devices (50.2%), lack of written protocols or guidelines (50.2%), inadequate training (47.1%), potential work risks (42.3%), and limited staffing (41.4%).

CONCLUSIONS

Although over half of ICU nurses exhibited relatively comprehensive knowledge of and positive attitudes to early mobilization, some misunderstandings, negativity, and barriers remain.

RELEVANCE TO CLINICAL PRACTICE

Training programmes should be conducted continuously, especially focused on common misunderstandings and negative attitudes. Organizational support is required to overcome barriers to the implementation of early mobilization.

摘要

背景

已建议危重症患者尽早开始活动。然而,在重症监护病房(ICU)中,早期活动的临床使用率仍然较低,呼吸治疗师和护士是中国早期活动的主要执行者。

目的

本研究旨在调查 ICU 护士对 ICU 患者早期活动的知识、态度和感知障碍。

设计

采用描述性和横断面设计。

方法

采用横断面设计,通过智能手机上的“腾讯微信”应用程序,用电子问卷对 227 名 ICU 护士进行 ICU 患者早期活动的知识和态度评估。

结果

作为中国 ICU 患者早期活动的主要执行者,超过一半的 ICU 护士通过了知识测试(得分≥20/25 分),对早期活动持积极态度(得分 45/55 分)。护士对早期活动的益处和停止指征有很好的了解(超过 96.5%);然而,他们对早期活动适用人群和早期活动监测指标的理解较差(低于 51.1%),39.2%的护士不支持常规对 ICU 患者实施早期活动。他们认为的主要障碍是工作量非常大(76.8%)、设备不足(50.2%)、缺乏书面方案或指南(50.2%)、培训不足(47.1%)、潜在工作风险(42.3%)和人员配备不足(41.4%)。

结论

尽管超过一半的 ICU 护士对早期活动有相对全面的知识和积极的态度,但仍存在一些误解、消极态度和障碍。

临床意义

应持续开展培训计划,特别是针对常见的误解和消极态度。需要组织支持来克服早期活动实施的障碍。

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