Western Sydney University, School of Nursing and Midwifery, Australia; Department of Emergency, Westmead Hospital, Australia.
Western Sydney University, School of Nursing and Midwifery, Australia.
Int Emerg Nurs. 2023 Jul;69:101317. doi: 10.1016/j.ienj.2023.101317. Epub 2023 Jun 20.
Sepsis is a medical emergency requiring prompt recognition, and early administration of intravenous fluids and antibiotics. While compliance with appropriate and timely administration of intravenous fluids has been found to be poor, the reasons are not well understood. Therefore, we have explored the experiences and perceptions of emergency nurses and medical officers from four hospitals to identify the associated facilitators and barriers.
Qualitative design incorporating six focus group discussions and thematic analysis of data. A hybrid approach using both inductive and deductive reasoning was used.
Four key themes were developed: 1. Overcrowding and understaffing threaten appropriate fluid management in sepsis; 2. Variations in clinical practice results in suboptimal fluid management; 3. Challenges with clinical recognition of sepsis impedes timely fluid administration; 4. Top-down approach is necessary to improve fluid management.
Themes highlighted the specific challenges associated with fluid administration in sepsis in the emergency department setting providing potential strategies to be implemented to improve practice and ultimately patient outcomes.
脓毒症是一种医疗急症，需要迅速识别，并尽早给予静脉补液和抗生素治疗。虽然已经发现静脉补液的适当和及时给予的依从性很差，但原因尚不清楚。因此，我们探索了来自四家医院的急诊护士和医生的经验和看法，以确定相关的促进因素和障碍。
采用定性设计，包括六次焦点小组讨论和主题数据分析。使用了归纳和演绎推理相结合的混合方法。
确定了四个关键主题：1. 过度拥挤和人手不足威胁脓毒症的适当液体管理；2. 临床实践中的差异导致液体管理不理想；3. 脓毒症的临床识别挑战阻碍了及时的液体给药；4. 需要自上而下的方法来改善液体管理。
这些主题突出了急诊科脓毒症液体管理中存在的具体挑战，为改善实践并最终改善患者结局提供了潜在的策略。
