Sjöberg Carina, Ringdal Mona, Jildenstål Pether
Department of Medicine and Health Sciences, Lund University, 223 62 Lund, Sweden.
Department of Anaesthesiology, Surgery and Intensive Care, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
Children (Basel). 2024 Aug 21;11(8):1021. doi: 10.3390/children11081021.
Measuring and interpreting vital signs in pediatric patients recovering from anaesthesia, particularly those up to 36 months old, is challenging. Nurses' decision-making regarding the level of monitoring must balance patient safety with individualized care. This study aimed to explore the perceptions of critical care nurses and registered nurse anesthetists regarding their experiences and actions when making decisions about vital sign monitoring for children in post-anesthesia care units (PACUs).
A qualitative study utilizing the critical incident technique was conducted. Interviews were performed with a purposeful sample of 17 critical care nurses and registered nurse anaesthetists from two hospitals.
Nurses reported that the rationale for decisions concerning the need for vital sign monitoring in children was both adequate and inadequate. Actions were taken to adjust the monitoring of vital signs, optimizing conditions for assessment and ensuring the child's safe recovery.
The complexity of accurately monitoring children makes it challenging for nurses in the PACU to adhere to guidelines. Evidence-based care and safety are compromised when technology has limitations and is not adapted for paediatric use, leading to a greater reliance on experience and clinical assessment. This reliance on experience is crucial for reliable assessment but also entails accepting greater risks.
在麻醉恢复阶段的儿科患者,尤其是36个月及以下的患儿中测量和解读生命体征具有挑战性。护士在决定监测水平时,必须在患者安全和个性化护理之间取得平衡。本研究旨在探讨重症监护护士和注册麻醉护士对于在麻醉后护理单元(PACU)为儿童进行生命体征监测决策时的经历和行为的看法。
采用关键事件技术进行定性研究。对来自两家医院的17名重症监护护士和注册麻醉护士进行了有目的抽样访谈。
护士们表示,关于儿童生命体征监测必要性的决策依据既有充分的,也有不充分的。采取了行动来调整生命体征监测,优化评估条件并确保患儿安全恢复。
准确监测儿童的复杂性使得PACU的护士难以遵循指南。当技术存在局限性且不适用于儿科时,循证护理和安全性会受到影响,导致对经验和临床评估的更大依赖。这种对经验的依赖对于可靠评估至关重要,但也意味着要接受更大的风险。