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重症监护病房工作人员对连续性肾脏替代治疗的知识、态度、实践、需求及实施现状:对中国中部和南部66家医院的调查

Knowledge, attitude, practice, needs, and implementation status of intensive care unit staff toward continuous renal replacement therapy: a survey of 66 hospitals in central and South China.

作者信息

Yu Xiaoyan, Ouyang Lin, Li Jinxiu, Peng Ying, Zhong Dingming, Yang Huan, Zhou Yanyan

机构信息

Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Hunan Provincial Center for Critical Care Medicine and Clinical Research in Smart Healthcare, Changsha, Hunan, China.

出版信息

BMC Nurs. 2024 Apr 26;23(1):281. doi: 10.1186/s12912-024-01953-6.

Abstract

BACKGROUND

Continuous renal replacement therapy (CRRT) is a commonly utilized form of renal replacement therapy (RRT) in the intensive care unit (ICU). A specialized CRRT team (SCT, composed of physicians and nurses) engage playing pivotal roles in administering CRRT, but there is paucity of evidence-based research on joint training and management strategies. This study armed to evaluate the knowledge, attitude, and practice (KAP) of ICU staff toward CRRT, and to identify education pathways, needs, and the current status of CRRT implementation.

METHODS

This study was performed from February 6 to March 20, 2023. A self-made structured questionnaire was used for data collection. Descriptive statistics, T-tests, Analysis of variance (ANOVA), multiple linear regression, and Pearson correlation coefficient tests (α = 0.05) were employed.

RESULTS

A total of 405 ICU staff from 66 hospitals in Central and South China participated in this study, yielding 395 valid questionnaires. The mean knowledge score was 51.46 ± 5.96 (61.8% scored highly). The mean attitude score was 58.71 ± 2.19 (73.9% scored highly). The mean practice score was 18.15 ± 0.98 (85.1% scored highly). Multiple linear regression analysis indicated that gender, age, years of CRRT practice, ICU category, and CRRT specialist panel membership independently affected the knowledge score; Educational level, years of CRRT practice, and CRRT specialist panel membership independently affected the attitude score; Education level and teaching hospital employment independently affected the practice score. The most effective method for ICU staff to undergo training and daily work experience is within the department.

CONCLUSION

ICU staff exhibit good knowledge, a positive attitude and appropriately practiced CRRT. Extended CRRT practice time in CRRT, further training in a general ICU or teaching hospital, joining a CRRT specialist panel, and upgraded education can improve CRRT professional level. Considering the convenience of training programs will enhance ICU staff participation. Training should focus on basic CRRT principles, liquid management, and alarm handling.

摘要

背景

连续性肾脏替代治疗(CRRT)是重症监护病房(ICU)中常用的肾脏替代治疗(RRT)形式。一个由医生和护士组成的专业CRRT团队(SCT)在实施CRRT中发挥着关键作用,但关于联合培训和管理策略的循证研究较少。本研究旨在评估ICU工作人员对CRRT的知识、态度和实践(KAP),并确定教育途径、需求以及CRRT实施的现状。

方法

本研究于2023年2月6日至3月20日进行。采用自制的结构化问卷进行数据收集。使用描述性统计、t检验、方差分析(ANOVA)、多元线性回归和Pearson相关系数检验(α = 0.05)。

结果

来自中国中部和南部66家医院的405名ICU工作人员参与了本研究,共获得395份有效问卷。知识平均得分为51.46 ± 5.96(61.8%得分较高)。态度平均得分为58.71 ± 2.19(73.9%得分较高)。实践平均得分为18.15 ± 0.98(85.1%得分较高)。多元线性回归分析表明,性别、年龄、CRRT实践年限、ICU类别和CRRT专家组成员身份独立影响知识得分;教育水平、CRRT实践年限和CRRT专家组成员身份独立影响态度得分;教育水平和教学医院工作经历独立影响实践得分。ICU工作人员进行培训和日常工作经验积累的最有效方法是在科室内部。

结论

ICU工作人员对CRRT表现出良好的知识、积极的态度和适当的实践。延长在CRRT方面的实践时间、在综合ICU或教学医院接受进一步培训、加入CRRT专家组以及提升教育水平可以提高CRRT专业水平。考虑培训项目的便利性将提高ICU工作人员的参与度。培训应侧重于CRRT的基本原理、液体管理和警报处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5d3/11055233/d71bc32a7a32/12912_2024_1953_Fig1_HTML.jpg

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