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危重症患者院际转运中的护理:一项定性研究。

Caring for critically ill patients during interhospital transfers: A qualitative study.

机构信息

Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden.

Intensive Care Unit 57, Sunderby Hospital, Luleå, Sweden.

出版信息

Nurs Crit Care. 2021 Sep;26(5):333-340. doi: 10.1111/nicc.12598. Epub 2021 Feb 16.

Abstract

BACKGROUND

The coronavirus pandemic has resulted in an increased number of interhospital transfers of patients with artificial airways. The transfer of these patients is associated with risks and has been experienced as highly challenging, which needs to be further explored.

AIMS AND OBJECTIVES

To describe critical care nurses' experiences of caring for critically ill patients with artificial airways during interhospital transfers.

DESIGN

A cross-sectional study using a qualitative approach was conducted during spring 2020. Participants were critical care nurses (n = 7) from different hospitals (n = 2).

METHODS

The data were collected through semi-structured interviews based on an interview guide. A qualitative content analysis using an inductive approach was performed.

RESULTS

The analysis resulted in one main theme, "Preserving the safety in an unknown environment," and three sub-themes, "Being adequately prepared is essential to feel secure," "Feeling abandoned and overwhelmingly responsible," and "Being challenged in an unfamiliar and risky environment."

CONCLUSIONS

Critical care nurses experienced interhospital transfers of critically ill patients with artificial airways as complex and risky. It is essential to have an overall plan in order to prevent any unpredictable and acute events. Adequate communication and good teamwork are key to the safe transfer of a critically ill patient in that potential complications and dangers to the patient can be prevented.

RELEVANCE TO CLINICAL PRACTICE

Standardized checklists need to be created to guide the transfers of critically ill patients with different conditions. This would prevent failures based on human or system factors, such as lack of experience and lack of good teamwork.

摘要

背景

冠状病毒大流行导致需要转移的带有人工气道的患者数量增加。这些患者的转移存在风险,并且被认为极具挑战性,这需要进一步探讨。

目的

描述在医院间转运期间,重症监护护士对人工气道危重患者的护理经验。

设计

这是一项在 2020 年春季进行的横断面研究,采用定性方法。参与者为来自不同医院(n=2)的 7 名重症监护护士。

方法

数据收集采用基于访谈指南的半结构化访谈。采用归纳法进行定性内容分析。

结果

分析结果得出一个主要主题:“在未知环境中保护安全”,以及三个副主题:“充分准备是感到安全的关键”、“感到被抛弃和责任过重”和“在陌生和危险的环境中面临挑战”。

结论

重症监护护士认为医院间转运人工气道危重患者是复杂且具有风险的。为了防止任何不可预测的急性事件,制定全面的计划至关重要。充分的沟通和良好的团队合作是安全转运危重患者的关键,这样可以防止患者出现潜在的并发症和危险。

临床意义

需要创建标准化的核对清单,以指导不同病情的危重患者的转运。这将防止因人为或系统因素(如经验不足和团队合作不佳)导致的失败。

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