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标准化、多指标、数据质量和趋势分析:一项关于多学科视角改善重症监护早期活动监测的定性研究。

Standardisation, multi-measure, data quality and trending: A qualitative study on multidisciplinary perspectives to improve intensive care early mobility monitoring.

机构信息

Division of Pulmonary, Critical Care, & Sleep Medicine, School of Medicine, University of California, Davis, USA; Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, USA; Medical ICU, UC Davis Medical Center, UC Davis Health, Sacramento, USA.

Medical ICU, UC Davis Medical Center, UC Davis Health, Sacramento, USA.

出版信息

Intensive Crit Care Nurs. 2021 Apr;63:102949. doi: 10.1016/j.iccn.2020.102949. Epub 2020 Nov 14.

Abstract

OBJECTIVE

To explore multi-clinician perspectives on intensive care early mobility, monitoring and to assess the perceived value of technology-generated mobility metrics to provide user feedback to inform research, practice improvement, and technology development.

METHODS

We performed a qualitative descriptive study. Three focus groups were conducted with critical care clinicians, including nurses (n = 10), physical therapists (n = 8) and physicians (n = 8) at an academic medical centre that implemented an intensive care early mobility programme in 2012. Qualitative thematic analysis was used to code transcripts and identify overarching themes.

FINDINGS

Along with reaffirming the value of performing early mobility interventions, four themes for improving mobility monitoring emerged, including the need for: 1) standardised indicators for documenting mobility; 2) inclusion of both quantitative and qualitative metrics to measure mobility 3) a balance between quantity and quality of data; and 4) trending mobility metrics over time.

CONCLUSION

Intensive care mobility monitoring should be standardised and data generated should be high quality, capable of supporting trend analysis, and meaningful. By improving measurement and monitoring of mobility, future researchers can examine the arc of activity that patients in the intensive care unit undergo and develop models to understand factors that influence successful implementation.

摘要

目的

探讨多临床医生对重症监护早期活动、监测的观点,并评估技术生成的活动计量指标的感知价值,为研究、实践改进和技术开发提供用户反馈。

方法

我们进行了一项定性描述性研究。在 2012 年实施重症监护早期活动计划的学术医疗中心,对包括护士(n=10)、物理治疗师(n=8)和医生(n=8)在内的重症监护临床医生进行了三次焦点小组讨论。使用定性主题分析对转录本进行编码并确定总体主题。

结果

除了重申进行早期活动干预的价值外,还出现了四个改善活动监测的主题,包括需要:1)标准化指标以记录活动;2)包括定量和定性指标来衡量活动;3)在数据数量和质量之间取得平衡;以及 4)随时间推移跟踪活动计量指标。

结论

重症监护活动监测应标准化,生成的数据应高质量,能够支持趋势分析,并且有意义。通过改善活动的测量和监测,未来的研究人员可以检查重症监护病房患者经历的活动轨迹,并开发模型来了解影响成功实施的因素。

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