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重症监护病房护士进行身体评估的实践和障碍:多中心横断面研究。

Practices and Barriers towards Physical Assessment among Nurses Working in Intensive Care Units: Multicenter Cross-Sectional Study.

机构信息

Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Biomed Res Int. 2021 Jul 14;2021:5524676. doi: 10.1155/2021/5524676. eCollection 2021.

Abstract

BACKGROUND

In the intensive care units, patients need special consideration and monitor frequently with appropriate physical assessment skills. Nurses working in the intensive care units play a fundamental role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Most of the nursing activities were poorly assessed in low-income countries including Ethiopia. Therefore, this study was aimed to assess the nurses' practice and barriers to physical assessment among critically ill patients in Northwest Ethiopia.

METHODS

An institution-based multicenter cross-sectional study was conducted at Amhara regional state referral hospitals from March to September 2019. A total of 299 nurses working in the intensive care units were recruited through the convenience sampling method. A 30-item physical assessment practice and 36-item barriers to nurses' use of the physical assessment scale inventory were used. The linear regression analysis model was fitted, and the adjusted unstandardized beta () coefficient with a 95% confidence interval was used. A value < 0.05 was considered statistically significant.

RESULTS

The mean score of the nurses' practice towards physical assessment among critically ill patients was 101.26 ± 24.99. Greater perceived reliance on others and technology ( = -0.78, 95% CI (-1.07, -0.48)), ward culture ( = -0.48, 95% CI (-0.85, -0.11)), specialty area ( = -1.46, 95% CI (-2.01, -0.90)), lack of nursing role model ( = -0.54, 95% CI (-1.06, -0.02)), being unmarried ( = -6.10, 95% CI (1.75, 10.46)), taken training ( = 11.53, 95% CI (6.34, 16.72)), and knowledge score ( = 2.81, 95% CI (2.00, 3.63)) were the factors significantly associated with the nurses' practice score towards physical assessment. Reliance on others and technology towards physical assessment practice was the most important barrier followed by ward culture and specialty area.

CONCLUSION

Nurses working in the intensive care units had a good practice towards physical assessment among critically ill patients. Hence, to increase the practice towards physical assessment in intensive care settings, especially for married nurses, experienced critical care nurses, and specialist professionals, practice support training, modifying ward environment, and educational support care are recommended.

摘要

背景

在重症监护病房,患者需要特别关注,并经常使用适当的体格评估技能进行监测。重症监护病房的护士通过持续评估和对健康状况变化的反应,在发现有恶化风险的患者方面发挥着重要作用。包括埃塞俄比亚在内的许多低收入国家对大部分护理活动的评估都很差。因此,本研究旨在评估西北埃塞俄比亚重症监护病房中护士对危重症患者进行体格评估的实践情况和障碍。

方法

这是一项 2019 年 3 月至 9 月在阿姆哈拉州地区转诊医院进行的基于机构的多中心横断面研究。采用便利抽样法招募了 299 名在重症监护病房工作的护士。使用了 30 项体格评估实践和 36 项护士使用体格评估量表的障碍量表。拟合线性回归分析模型,使用 95%置信区间的标准化未调整β()系数。 值 < 0.05 被认为具有统计学意义。

结果

危重症患者中护士体格评估实践的平均得分为 101.26 ± 24.99。对他人和技术的依赖程度更高( = -0.78,95%置信区间[-1.07,-0.48])、病房文化( = -0.48,95%置信区间[-0.85,-0.11])、专业领域( = -1.46,95%置信区间[-2.01,-0.90])、缺乏护理榜样( = -0.54,95%置信区间[-1.06,-0.02])、未婚( = -6.10,95%置信区间[1.75,10.46])、接受过培训( = 11.53,95%置信区间[6.34,16.72])和知识得分( = 2.81,95%置信区间[2.00,3.63])与护士对体格评估的实践评分显著相关。对他人和技术的依赖是体格评估实践的最重要障碍,其次是病房文化和专业领域。

结论

重症监护病房的护士对危重症患者的体格评估实践较好。因此,为了提高重症监护环境中对体格评估的实践,特别是对已婚护士、有经验的重症监护护士和专科专业人员,建议提供实践支持培训、修改病房环境和教育支持护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7426/8294977/530ac4543df9/BMRI2021-5524676.001.jpg

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