Local Health Autority of Caserta.
Corporate Research, Robert Bosch GmbH, Stuttgart (Germany).
Acta Biomed. 2022 May 12;93(S2):e2022144. doi: 10.23750/abm.v93iS2.12716.
Patient-ventilator asynchronies (PVA) are associated to negative outcomes for patients: increased respiratory work, mechanical ventilation time and ICU length of stay, and mortality. Some studies described the positive impact of a training intervention on the knowledge and attitudes of nurses in detecting PVA. The aim of this study was to evaluate the efficacy of a training intervention focused on detection of PVA.
A before-after design on a single group of nursing students was used. The training intervention about detection of the correct respiratory waveform through graphic monitoring was conducted in a single edition course of 2 hours, for 25 participants. Measurements of correct detection of PVA through specific competency assessment tool were performed before (T0), immediately after (T1) and at 1 month (T2) from the training intervention between January and February 2020.
19 Nurse students completed the training. A total of 50 questionnaires were distributed (T0; n=19; T1; n=19; T2; n=12). PVA were correctly detected in 67.5% (77) of cases. Statistically significant difference There were differences in trainees performance between T0 and T1 [77,2% (CI95%: 68,7% - 85,8%; p=0.001)] and between T0 and T2 [75% (CI95%: 65,3% - 84,7%; p=0.001]. No significant difference was recorded between T1 and T2 (p=0.83) Conclusions: Nursing students increased their performance on analysis of the graphic monitoring of the respiratory waveforms and detection of asynchronies after a basic training intervention. These skills were retained after 1 month. Nurse student trained about PVA increased their competence potentially employed in critical care settings.
患者-呼吸机不同步(PVA)与患者不良预后相关,如增加呼吸功、机械通气时间和 ICU 住院时间以及死亡率。一些研究描述了培训干预对护士检测 PVA 的知识和态度的积极影响。本研究旨在评估一项专注于检测 PVA 的培训干预的效果。
采用单组前后设计,对 25 名护理学生进行了一次 2 小时的培训干预,培训内容为通过图形监测检测正确的呼吸波形。在 2020 年 1 月至 2 月期间,使用特定的能力评估工具,在培训干预前(T0)、干预后即刻(T1)和 1 个月后(T2)对 PVA 的正确检测进行测量。
共有 19 名护士学生完成了培训。共发放了 50 份问卷(T0:n=19;T1:n=19;T2:n=12)。正确检测到 PVA 的比例为 67.5%(77 例)。研究对象在 T0 和 T1 之间[77.2%(95%CI:68.7% - 85.8%;p=0.001)]和 T0 和 T2 之间[75%(95%CI:65.3% - 84.7%;p=0.001]的表现存在差异。T1 和 T2 之间无显著差异(p=0.83)。结论:经过基础培训干预后,护理学生在分析呼吸波形的图形监测和检测不同步方面的表现有所提高。这些技能在 1 个月后仍能保持。接受过 PVA 培训的护士学生提高了他们在重症监护环境中潜在的能力。