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体外膜肺氧合(ECMO)教育速成课后,护士照顾接受 ECMO 支持的 COVID-19 患者的经验。

Experience of Nurses Caring for COVID-19 Patients Supported by Venovenous Extracorporeal Membrane Oxygenation (ECMO) After ECMO Educational Crash Course.

机构信息

Transplant Institute, New York University Langone Health, New York, New York.

Department of Nursing, New York University Langone Health, New York, New York.

出版信息

ASAIO J. 2023 Mar 1;69(3):267-271. doi: 10.1097/MAT.0000000000001807. Epub 2022 Oct 3.

Abstract

During a 6 week period beginning early March 2020, 30 patients with severe coronavirus disease 2019 (COVID-19) were supported with venovenous extracorporeal membrane oxygenation (ECMO). This volume increase mandated rapidly training 116 nurses with no prior ECMO experience via a 2 hour crash course. A qualitative study using semistructured, in-depth interviews was conducted to evaluate the experiences of this unique nursing cohort. Fourteen registered nurses meeting inclusion criteria of no prior ECMO experience, attendance of ECMO educational crash course, direct assignment of COVID-19 patients requiring ECMO, and willingness to consent to recorded interviews participated in the study. Two semistructured interviews were conducted, audio recorded, and transcribed verbatim. Thematic analysis of the interviews was completed using Colaizzi's phenomenological method. Six themes identified were anxiety and fear of patient harm, isolation and depersonalization, value of didactic education with reinforced clinical experience, professional growth, importance of team collaboration, and pride and gratitude. Subthemes were additionally extracted. Nurses faced multiple obstacles during the pandemic. ECMO added a layer of complexity, as these patients required labor-intensive, high acuity nursing care. The impact of the pandemic and its unique challenges on nursing and medical staff warrants further investigation.

摘要

在 2020 年 3 月初开始的 6 周期间,30 名患有严重 2019 年冠状病毒病(COVID-19)的患者接受了静脉-静脉体外膜肺氧合(ECMO)支持。这种容量增加需要迅速培训 116 名没有 ECMO 经验的护士,通过 2 小时的速成课程进行培训。使用半结构化深入访谈进行了一项定性研究,以评估这一独特护理群体的经验。14 名符合纳入标准的注册护士参加了这项研究,这些标准包括没有 ECMO 经验、参加 ECMO 教育速成课程、直接负责需要 ECMO 的 COVID-19 患者,以及愿意同意录制访谈。进行了两次半结构化访谈,录音并逐字转录。使用科拉齐的现象学方法对访谈进行了主题分析。确定了 6 个主题,分别是对患者伤害的焦虑和恐惧、孤立和非人性化、有针对性的教育与强化临床经验的价值、专业成长、团队合作的重要性以及自豪和感激。还提取了子主题。护士在大流行期间面临多种障碍。ECMO 增加了一层复杂性,因为这些患者需要劳动密集型、高 acuity 的护理。大流行及其独特挑战对护理和医务人员的影响值得进一步调查。

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