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荷兰全国性调查:COVID-19 重症监护病房患者气道护理干预与俯卧位通气的护理实践

Nursing Practice of Airway Care Interventions and Prone Positioning in ICU Patients with COVID-19-A Dutch National Survey.

作者信息

Esmeijer Andrea A, van der Ven Fleur, Koornstra Eveline, Kuipers Laurien, van Oosten Paula, Swart Pien, Valk Christel M, Schultz Marcus J, Paulus Frederique, Stilma Willemke

机构信息

Department of Intensive Care, Amsterdam University Medical Center, Location VUmc, 1081 HV Amsterdam, The Netherlands.

Department of Intensive Care, Amsterdam University Medical Center, Location AMC, 1105 AZ Amsterdam, The Netherlands.

出版信息

J Clin Med. 2024 Mar 29;13(7):1983. doi: 10.3390/jcm13071983.

Abstract

: Airway care interventions and prone positioning are used in critically ill patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) to improve oxygenation and facilitate mucus removal. At the onset of the COVID-19 pandemic, the decision-making process regarding the practice of airway care interventions and prone positioning was challenging. To provide an overview of the practice of airway care interventions and prone positioning during the second wave of the pandemic in the Netherlands. Web-based survey design. Seventy ICU nurses, each representing one intensive care in the Netherlands, were contacted for participation. Potential items were generated based on a literature search and formulated by a multidisciplinary team. Questions were pilot tested for face and construct validity by four intensive care nurses from four different hospitals. The response rate was 53/77 (69%). This survey revealed widespread use of airway care interventions in the Netherlands in COVID-19 patients, despite questionable benefits. Additionally, prone positioning was used in invasively and non-invasively ventilated patients. The use of airway care interventions and prone positioning is time consuming and comes with the production of waste. Further research is needed to assess the effectiveness, workload, and environmental impact of airway care interventions and prone positioning.

摘要

气道护理干预措施和俯卧位通气被用于入住重症监护病房(ICU)的2019冠状病毒病(COVID-19)危重症患者,以改善氧合并促进痰液清除。在COVID-19大流行初期,关于气道护理干预措施和俯卧位通气实践的决策过程具有挑战性。为了概述荷兰第二波大流行期间气道护理干预措施和俯卧位通气的实践情况。采用基于网络的调查设计。联系了荷兰70名ICU护士,每人代表一家重症监护机构参与调查。潜在项目基于文献检索生成,并由多学科团队制定。问题由来自四家不同医院的四名重症监护护士进行了表面效度和结构效度的预测试。回复率为53/77(69%)。这项调查显示,尽管益处存疑,但荷兰的COVID-19患者中广泛使用了气道护理干预措施。此外,俯卧位通气用于有创和无创通气患者。气道护理干预措施和俯卧位通气的使用耗时且会产生废物。需要进一步研究以评估气道护理干预措施和俯卧位通气的有效性、工作量及环境影响。

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Nurse-led implementation of awake prone positioning.护士主导实施清醒俯卧位。
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