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护士主导的异丙酚镇静培训课程和在消化内镜检查程序中的异丙酚给药:文献的范围综述。

Nurse-Administered Propofol Sedation Training Curricula and Propofol Administration in Digestive Endoscopy Procedures: A Scoping Review of the Literature.

机构信息

Andrea Minciullo, MSN, RN, is Head Nurse, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Lucia Filomeno, MSN, RN, is Research Fellow, Sapienza University of Rome, Rome, Italy.

出版信息

Gastroenterol Nurs. 2024;47(1):33-40. doi: 10.1097/SGA.0000000000000780. Epub 2023 Nov 8.

Abstract

Although efficacy and safety of nonanesthesiologist administration of propofol and nurse-administered propofol sedation practices have been amply demonstrated in patients at low American Society of Anesthesiologists physical status risk, they are still severely limited. To date, it is quite difficult to find a protocol or a shared training program. The aim of the study was to verify requirements, types of training, and operating methods described in the literature for the administration of propofol by a nurse. A scoping review of the literature was conducted in accordance with the PRISMA-ScR guidelines and in line with Arksey and O'Malley's framework, within four main databases of biomedical interest: MEDLINE, CINAHL, Scopus, and Web of Science. We selected studies published during the last 20 years, including only nurses not trained in anesthesia. Seventeen articles were eligible. Despite the differences between the training and administration methods, efficacy and safety of deep sedation managed by trained nurses were comparable, just like when sedation was administered by certified registered nurse anesthetists. Training programs have been investigated in detail by only a small number of studies, although its efficacy and safety have been widely demonstrated. It is important, then, to collect evidence that allows developing of unified international guidelines for training methods to offer safe and cost-effective quality sedation.

摘要

尽管在低美国麻醉医师协会身体状况风险的患者中,非麻醉医师管理丙泊酚和护士管理丙泊酚镇静实践的疗效和安全性已经得到充分证明,但这些实践仍然受到严重限制。迄今为止,很难找到一个协议或共享的培训计划。本研究的目的是验证文献中描述的护士管理丙泊酚的要求、培训类型和操作方法。根据 PRISMA-ScR 指南并遵循 Arksey 和 O'Malley 的框架,在四个主要的生物医学数据库中(MEDLINE、CINAHL、Scopus 和 Web of Science)进行了文献范围的回顾。我们选择了在过去 20 年中发表的研究,仅包括未经麻醉培训的护士。有 17 篇文章符合条件。尽管培训和管理方法存在差异,但经过培训的护士管理的深度镇静的疗效和安全性是可比的,就像由认证注册护士麻醉师管理镇静一样。尽管已经有少数研究详细研究了培训计划,但它的疗效和安全性已经得到了广泛证明。因此,重要的是收集证据,制定统一的国际培训方法指南,以提供安全和具有成本效益的高质量镇静。

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