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多中心研究:多学科 ICU 团队成员对早期活动的信念。

A multisite study of multidisciplinary ICU team member beliefs toward early mobility.

机构信息

Vanderbilt University School of Nursing; 461 21st Ave South, Nashville, TN 37240, USA; Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center at Vanderbilt, Nashville, TN, USA; Vanderbilt Center for Clinical Quality and Implementation Research (CCQIR), Nashville, TN, USA.

Vanderbilt University School of Nursing; 461 21st Ave South, Nashville, TN 37240, USA.

出版信息

Heart Lung. 2021 Jan-Feb;50(1):214-219. doi: 10.1016/j.hrtlng.2020.09.021. Epub 2020 Oct 14.

Abstract

BACKGROUND

Early mobility is underutilized in critical care.

OBJECTIVE

Describe multidisciplinary intensive care unit (ICU) providers beliefs about the conduct of early mobility during critical illness.

METHODS

A 7-item elicitation survey was administered to a multidisciplinary sample of ICU team members. We conducted independent thematic analysis of n = 95 surveys.

RESULTS

Analysis resulted in three themes: immediate risk vs. long-term reward conflict, nurse is the initiator and coordinator of early mobilization, and situational factors. Staffing was the primary facilitator and barrier to early mobility. Enablers included protection from complications of hospitalization, reduced hospital length of stay, and improved patient morale. Barriers strongly revolved around team member risk aversion (e.g., falls, hemodynamic instability, line dislodgment). Nurses were equally identified as positive and negative referents for early mobility.

CONCLUSIONS

Strong positive and negative attitudinal beliefs were elicited. Early mobility is a protective behavior that requires sufficient numbers of trained staff and equipment.

摘要

背景

在重症监护中,早期活动的应用不足。

目的

描述重症监护病房(ICU)多学科医护人员对危重病患者进行早期活动的行为的信念。

方法

对 ICU 团队成员进行了 7 项启发式调查。我们对 n=95 份调查进行了独立的主题分析。

结果

分析产生了三个主题:即时风险与长期回报的冲突、护士是早期活动的发起者和协调者、情境因素。人员配备是早期活动的主要促进因素和障碍。早期活动的促进因素包括预防住院并发症、缩短住院时间和提高患者士气。障碍主要围绕团队成员的避险(如跌倒、血流动力学不稳定、管路移位)。护士同样被认为是早期活动的积极和消极参照。

结论

得出了强烈的积极和消极态度信念。早期活动是一种保护行为,需要足够数量的训练有素的工作人员和设备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e125/7738426/5692ff76dc73/nihms-1637952-f0001.jpg

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