Spinner S, Gibson E, Wrobel H, Spitzer A R
Neonatal Netw. 1995 Dec;14(8):39-46.
Appropriate and effective nursing intervention is an essential element in determining how the family responds to the monitor in the home. Accurate assessment of the family system and dynamics provides the basis for a plan of care. The family's and infant's specific needs must be addressed. Careful implementation of the plan allows for changes and unexpected outcomes. Frequent evaluation of monitoring is necessary to determine if a change in the plan of care is needed. Recent changes in home apnea monitoring technology are rapidly altering the care of infants at risk for apnea and SIDS. The advent of the documented or recording monitor has the potential to demystify the events occurring while the infant is being monitored. Parents can get answers about their infant as quickly as a telephone call. The clinician can differentiate between a true and a false alarm and reassure the parents accordingly. Documenting false events and shallow-breathing alarms will potentially reduce the duration of monitoring, decreasing costs to the entire health care system. Documented monitoring is a valuable tool for nurses. For the staff nurse, clinical observation can be validated through trending and print out of events can be done at the bedside. For the advanced practice nurse, management of care can become more efficient through remote monitoring via modem. Patient teaching can be followed with immediate feedback. Monitors may assist in allaying anxiety in families who have lost children to SIDS or had an unexpected death in a previous sibling. Families may feel less anxious about having an "at risk" child in the home if the events are continuously being recorded. Length of hospital stay may decrease initially, with fewer rehospitalizations. Nursing research in these areas is necessary. Evaluating events occurring in the home may also help shed light on the enigma of SIDS. Several SIDS deaths have been recorded on documented monitors. If we can pinpoint exactly what takes place prior to and immediately after a SIDS episode, the enigma that has had physicians puzzled for so long may finally begin to unravel.
恰当且有效的护理干预是决定家庭如何应对家中监护仪的关键因素。对家庭系统及动态的准确评估为护理计划提供了基础。必须满足家庭和婴儿的特定需求。精心实施护理计划能应对各种变化及意外情况。定期评估监护情况对于确定是否需要调整护理计划很有必要。家庭呼吸暂停监护技术的最新变革正在迅速改变对有呼吸暂停和婴儿猝死综合征风险婴儿的护理。有记录功能的监护仪的出现有可能揭开婴儿监护期间所发生事件的神秘面纱。家长打个电话就能迅速得到有关其婴儿的答案。临床医生能够区分真正的警报和误报，并据此安抚家长。记录误报事件和浅呼吸警报有可能缩短监护时间，降低整个医疗保健系统的成本。有记录的监护对护士来说是一种宝贵工具。对于普通护士而言，临床观察可通过趋势分析得到验证，且能在床边打印出事件记录。对于高级执业护士来说，通过调制解调器进行远程监护可提高护理管理效率。患者教育能得到即时反馈。监护仪可能有助于减轻那些因婴儿猝死综合征失去孩子或此前有同胞意外死亡的家庭的焦虑。如果事件持续被记录下来，家庭对于家中有“风险”婴儿可能会不那么焦虑。住院时间最初可能会缩短且再次住院的情况会减少。在这些领域开展护理研究很有必要。评估家中发生的事件也可能有助于揭示婴儿猝死综合征之谜。已有数起婴儿猝死综合征死亡事件被有记录功能的监护仪记录下来。如果我们能确切查明婴儿猝死综合征发作之前及之后紧接着发生了什么，这个让医生们困惑已久的谜团或许最终会开始解开。
