一种用于人工胰腺围手术期血糖控制的跨专业工作手册的实用性。

Usefulness of an interprofessional work manual for perioperative glucose control of an artificial pancreas.

机构信息

Department of Nursing, Kochi Medical School, Nankoku, Japan.

Kochi Nursing Association, Kochi, Japan.

出版信息

Artif Organs. 2024 Nov;48(11):1308-1312. doi: 10.1111/aor.14821. Epub 2024 Jul 4.

DOI:10.1111/aor.14821

PMID:38963003

Abstract

BACKGROUND

A closed-loop bedside-type artificial pancreas for perioperative glucose control has previously been introduced. However, artificial pancreas therapy was often interrupted due to continuous blood sampling failure. We developed an interprofessional work manual to reduce the interruption time of artificial pancreatic therapy for perioperative blood glucose control due to continuous blood sampling failure. This study aimed to investigate the usefulness of this manual.

METHODS

The manual consisted of the following sections: (1) the roles of the professionals in the preparation and management of the artificial pancreas, (2) how to address continuous blood sampling failure, and (3) checkpoints for interprofessional transfer of the artificial pancreas. We compared the results before the introduction of the manual and 2 years after the introduction of the manual.

RESULTS

There were 35 and 37 patients in the Before and After groups, respectively. There were no significant differences in patient backgrounds between the two groups, although there was significantly less blood loss in the After group (1164 vs. 366 mL; p < 0.001). The mean artificial pancreas therapy and artificial pancreas therapy interruption times were 847 min and 20 min, respectively. Artificial pancreas therapy interruption time (34 vs. 8 min; p = 0.078) and time per interruption (24 vs. 4 min; p < 0.001) were significantly shorter in the After group than in the Before group.

CONCLUSIONS

The interprofessional working manual was useful in reducing the artificial pancreatic therapy interruption time for perioperative glucose control.

摘要

背景

先前已经介绍了一种用于围手术期血糖控制的闭环床边型人工胰腺。然而，由于连续采血失败，人工胰腺治疗经常中断。我们开发了一种跨专业工作手册，以减少由于连续采血失败而导致的围手术期血糖控制的人工胰腺治疗中断时间。本研究旨在探讨该手册的实用性。

方法

该手册包括以下部分：（1）专业人员在人工胰腺的准备和管理中的角色，（2）如何解决连续采血失败的问题，以及（3）人工胰腺跨专业转移的检查点。我们比较了手册引入前和引入后 2 年的结果。

结果

在 Before 和 After 组中，分别有 35 名和 37 名患者。两组患者的背景无显著差异，尽管 After 组的失血量明显较少（1164 与 366ml；p<0.001）。人工胰腺治疗和人工胰腺治疗中断时间的平均值分别为 847 分钟和 20 分钟。人工胰腺治疗中断时间（34 与 8 分钟；p=0.078）和每次中断的时间（24 与 4 分钟；p<0.001）在 After 组均明显短于 Before 组。