Semyon Melnikov is a senior lecturer in the Department of Nursing, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Alex Furmanov is a head nurse of neuro and cardiothoracic surgery intensive care units (ICUs) at Hadassah Medical Center, Ein Kerem, Jerusalem, Israel.
Crit Care Nurse. 2021 Jun 1;41(3):e1-e8. doi: 10.4037/ccn2021415.
By July 2020, the Extracorporeal Life Support Organization had documented more than 133 000 extracorporeal membrane oxygenation (ECMO) implementations, with more than 61 000 implementations in adult patients. No clear policies regarding the authority and responsibility of nursing staff in the treatment of ECMO-supported patients are currently available.
To formulate evidence-based recommendations for nursing care of ECMO-supported patients.
The National Head Nurse's office and the Professional Guidelines Department in the Nursing Division of Israel's Ministry of Health formed the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients to address concerns regarding the current state of professional nursing practice in the care of these patients. The Professional Advisory Committee brought together 15 senior Israeli ECMO nursing experts who explored the potential of registered nurses in caring for ECMO-supported patients, considered the competencies of nurses treating ECMO-supported patients, discussed training programs and health care policy, and examined nursing outcomes for quality assurance.
The Professional Advisory Committee formulated recommendations regarding the following priority issues: (1) determining boundaries of professional authority and nurses' responsibilities, including designated activities for different professional ranks of registered nurses; (2) providing appropriate content for the training programs offered, such as generic/basic, above-basic, and clinical specialization nursing programs; and (3) defining relevant quality measures for nursing treatment of ECMO-supported patients.
Introducing international standards would ensure the safety and effectiveness of nursing care for ECMO-supported patients through quality and risk management and establishment of new evidence-based nursing practices.
截至 2020 年 7 月,体外生命支持组织(Extracorporeal Life Support Organization)已记录了超过 133000 例体外膜氧合(ECMO)实施案例,其中成人患者超过 61000 例。目前,尚无关于护理人员在 ECMO 支持患者治疗方面的权限和责任的明确政策。
制定 ECMO 支持患者护理的循证建议。
以色列卫生部国家护士长办公室和护理司专业准则司成立了 ECMO 支持患者护理专业实践咨询委员会,以解决当前护理此类患者的专业护理实践状况所引发的关注。专业咨询委员会召集了 15 名以色列资深 ECMO 护理专家,探讨了注册护士在照顾 ECMO 支持患者方面的潜力,考虑了治疗 ECMO 支持患者的护士的能力,讨论了培训计划和医疗保健政策,并研究了护理结果以确保质量保证。
专业咨询委员会针对以下优先事项制定了建议:(1)确定专业权限和护士职责的界限,包括为不同级别的注册护士指定活动;(2)为提供的培训计划提供适当的内容,例如通用/基础、高于基础和临床专业化护理计划;(3)定义 ECMO 支持患者护理相关的质量措施。
引入国际标准将通过质量和风险管理以及建立新的循证护理实践来确保 ECMO 支持患者的护理安全和有效性。