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患者安全检查表指导下的麻醉护理行为评估:麻醉程序中的护理(PSC/NAP):一项横断面研究。

Evaluation of Nursing Actions in Anesthesia Guided by the Patient Safety Checklist: Nursing in Anesthetic Procedure (PSC/NAP): A Cross-Sectional Study.

机构信息

Faculty of Medical Sciences of Santa Casa São Paulo, São Paulo, Brazil.

University of São Paulo, School of Nursing, Medical-Surgical Nursing Department, São Paulo, Brazil.

出版信息

J Perianesth Nurs. 2020 Dec;35(6):635-641. doi: 10.1016/j.jopan.2020.03.017. Epub 2020 Jul 29.

Abstract

PURPOSE

This study aimed to evaluate the implementation of nursing actions in anesthesia guided by the Patient Safety Checklist: Nursing Anesthetic Procedure and the difficulties in performing patient care.

DESIGN

A cross-sectional study.

METHODS

Nursing actions were evaluated in 282 anesthetic procedures of adult patients undergoing general anesthesia in three periods of anesthesia in a private hospital operating room in Brazil, from January to July 2018. The evaluated outcomes were the number of items performed by nurses during anesthesia periods and limitations for applying the Patient Safety Checklist: Nursing Anesthetic Procedure instrument.

FINDINGS

Execution of the nursing actions presented a mean percentage of 85.6, highlighting the anesthetic induction stage and differences between the periods before induction and reversal. The main items not performed in evaluating the nursing care in anesthesia were as follows: the anesthesia equipment test (84; 29.78%) in the preinduction period; the evaluation of adequate ventilation (132; 46.81%) in the induction period; and the tracheal aspiration assistance (62; 21.98%) during reversal. Receiving a call from another room with care interruption was highlighted among the nurses' justifications for not performing the activities and difficulty in continuing care because of shift change.

CONCLUSIONS

The execution of nursing care actions in anesthesia mainly occurred during the period related to induction, with limitations because of dimensioning of operating rooms and simultaneous procedures.

摘要

目的

本研究旨在评估麻醉中患者安全检查表(护理麻醉程序)指导下护理操作的实施情况,以及患者护理实施过程中的难点。

设计

横断面研究。

方法

2018 年 1 月至 7 月,在巴西一家私立医院手术室的三个麻醉阶段,对 282 例接受全身麻醉的成年患者的麻醉护理操作进行评估。评估结果为护士在麻醉期间实施的项目数量以及应用患者安全检查表(护理麻醉程序)工具的限制。

结果

护理操作的执行率平均为 85.6%,其中以麻醉诱导阶段和诱导前与逆转期之间的差异最为显著。在评估麻醉护理过程中,未执行的主要项目如下:诱导前阶段的麻醉设备测试(84 项;29.78%);诱导期的适当通气评估(132 项;46.81%);以及逆转期的气管抽吸辅助(62 项;21.98%)。护士未执行这些活动的理由是接到其他房间的电话导致护理中断,以及由于班次变更而难以继续护理。

结论

麻醉中护理操作的执行主要发生在与诱导相关的时期,但由于手术室的尺寸和同时进行的程序,存在一定的限制。

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