School of Nursing and Midwifery, Monash University, McMahons Road, Frankston, Victoria, Australia; Monash Health, Dandenong Hospital, 135 David Street, Dandenong, Victoria, Australia. Electronic address: https://twitter.com/@AuxilliaMadhuvu.
School of Nursing and Midwifery, Monash University, McMahons Road, Frankston, Victoria, Australia; Plymouth University/Royal Devon and Exeter Hospital Clinical School, Drake Circus, Plymouth, Devon PL4 8AA, United Kingdom.
Intensive Crit Care Nurs. 2022 Feb;68:103133. doi: 10.1016/j.iccn.2021.103133. Epub 2021 Oct 27.
To explore health professional views of barriers to the use of evidence-based practice to prevent ventilator-associated events in intensive care units.
A qualitative descriptive study was conducted with nurses and doctors with more than six months experience caring for mechanically ventilated patients.
The study was conducted in two intensive care units, in large metropolitan health services in Victoria, Australia.
Individual semi-structured interviews were undertaken with 20 participants (16 nurses and 4 doctors) in 2019. Purposive sampling method was used until data saturation was reached. The interviews were held at the hospital in a private room away from their place of employment. The interview data were analysed using thematic analysis.
Four major themes were inductively identified from nine subthemes: i) prioritising specific situations, ii) inadequate use of evidence to underpin practice, iii) perception of inadequate staffing and equipment and, iv) inadequate training and knowledge of evidence-based guidelines.
These themes helped to explain previously reported deficits in nurses' knowledge of and adherence to evidence-based practice in intensive care. Findings suggest the need for a well-established policy to underpin practice. The barriers faced by nurses and doctors in preventing ventilator associated events need to be addressed to optimise quality of patient care in intensive care units.
探讨医护人员对使用循证实践预防重症监护病房呼吸机相关事件的障碍的看法。
对具有超过 6 个月机械通气患者护理经验的护士和医生进行了定性描述性研究。
该研究在澳大利亚维多利亚州两家大型都市卫生服务机构的两个重症监护病房进行。
2019 年对 20 名参与者(16 名护士和 4 名医生)进行了个人半结构化访谈。采用目的抽样法,直到达到数据饱和。访谈在医院的一个私人房间进行,远离他们的工作场所。使用主题分析对访谈数据进行分析。
从 9 个子主题中归纳出 4 个主要主题:i)优先考虑特定情况,ii)证据不足用于支持实践,iii)对人员配备和设备不足的看法,以及 iv)循证指南的培训和知识不足。
这些主题有助于解释之前报道的重症监护护士循证实践知识和遵守情况的不足。研究结果表明需要有一个完善的政策来支持实践。需要解决护士和医生在预防呼吸机相关事件方面面临的障碍,以优化重症监护病房的患者护理质量。