摘要
目的调查ICU护士对人工气道患者微误吸的评估现状,分析阻碍评估工作的影响因素。方法纳入广西14家三甲医院626名ICU护士作为研究对象。采用自制问卷调查ICU护士的一般资料、对人工气道患者微误吸的评估现状、评估人工气道患者微误吸的障碍因素。结果(1)70.3%(440/626)的ICU护士护理过发生微误吸的人工气道患者,66.0%(413/626)的ICU护士主动评估过人工气道患者微误吸的发生情况;分别有52.1%(326/626)、36.7%(230/626)、11.2%(70/626)的ICU护士认为可通过临床经验、痰液检验、医生诊断来识别微误吸;只有35.0%(219/626)的ICU护士接受过人工气道患者微误吸相关培训;有54.2%(339/626)的ICU护士认为人工气道相关知识不能满足临床工作需要。(2)ICU护士的个人层面障碍因素总均分为(2.49±0.86)分,最主要的障碍因素是个人缺乏相关知识;组织层面障碍因素总均分为(3.06±0.78)分,最主要的障碍因素是科室缺乏评估工具和条件;患者层面障碍因素总均分为(2.67±0.75)分,最主要的障碍因素是认为患者病情严重。(3)年龄≤25岁的ICU护士的人工气道患者微误吸评估障碍因素总得分高于年龄>25~35岁、年龄>45岁的ICU护士(P<0.05)。在护理过发生微误吸的人工气道患者、主动评估过人工气道患者微误吸发生情况、接受过人工气道患者微误吸相关培训、认为掌握的人工气道患者微误吸相关知识不能满足临床工作需要、对人工气道患者微误吸的重视程度应与ICU其他并发症一样等方面,持否定态度的ICU护士的人工气道患者微误吸评估障碍因素总得分高于持肯定态度的ICU护士(P<0.05)。结论目前ICU护士对人工气道患者微误吸评估的执行率较低,主要的阻碍因素是个人缺乏相关知识和技能、科室缺乏评估工具和条件等。
Objective To investigate the current status of ICU nurses on microaspiration assessment in artificial airway patients,and to analyze the influencing factors for obstruction of assessment works.Methods A total of 626 ICU nurses in 14 classⅢhospitals of Guangxi were enrolled as the research subjects.The self⁃designed questionnaire was used to investigate ICU nurses′general data,current status of ICU nurses on microaspiration assessment in artificial airway patients,and to evaluate obstacle factors for microaspiration in artificial airway patients.Results(1)70.3%(440/626)of ICU nurses had cared for artificial airway patients with microaspiration,66.0%(413/626)of ICU nurses had actively evaluated the occurrence states of artificial airway patients with microaspiration;moreover,52.1%(326/626),36.7%(230/626),and 11.2%(70/626)of ICU nurses believed that microaspiration can be recognized through clinical experience,sputum examination,and doctor′s diagnosis,respectively,whereas only 35.0%(219/626)of ICU nurses had received training related to microaspiration in patients with artificial airway;in addition,54.2%(339/626)of ICU nurses believed that knowledge related to artificial airway could not meet the demands for clinical works.(2)The total average score of personal obstacle factors of ICU nurses was 2.49±0.86,and the most important obstacle factor was lack of relevant knowledge of individuals.The total average score of organizational obstacle factors of ICU nurses was 3.06±0.78,and the most important obstacle factor was lack of assessment tools and conditions in the department.The total average score of patients obstacle factors of ICU nurses was 2.67±0.75,and the most important obstacle factor was the perception that patient was seriously ill.(3)The total score of assessing obstacle factors for microaspiration in patients with artificial airway of ICU nurses aged≤25 years old was higher than that of ICU nurses aged>25-35 years old and>45 years old(P<0.05).In the aspects of microaspiration occurrence in nursing patients with artificial airway,active assessment of the occurrence states of microaspiration in patients with artificial airway,relevant training receiving on microaspiration in patients with artificial airway,relevant knowledge of microaspiration in patients with artificial airway unsatisfied demands for clinical works,being the same with ICU other complications on degree of emphasis on microaspiration in patients with artificial airway,etc.,the total score of assessing obstacle factors for microaspiration of patients with artificial airway in ICU nurses with negative attitude was higher than that in ICU nurses with positive attitude(P<0.05).Conclusion At present,the implementation rate of microaspiration assessment in patients with artificial airway by ICU nurses is low.The main obstacle factors are the lack of relevant knowledge and skills of individuals,and the lack of assessment tools and conditions in the department,etc.
作者
邹莉
莫丽勤
吴丹霞
徐瑞馨
钟艳秋
陆海素
ZOU Li;MO Liqin;WU Danxia;XU Ruixin;ZHONG Yanqiu;LU Haisu(Intensive Care Unit of Cardiothoracic Surgery Department,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China)
出处
《广西医学》
CAS
2024年第5期645-652,共8页
Guangxi Medical Journal
基金
广西壮族自治区临床重点专科建设项目(桂卫医发〔2022〕21号)。
关键词
重症监护室
护士
人工气道
微误吸
评估
障碍因素
广西壮族自治区
Intensive Care Unit
Nurses
Artificial airway
Microaspiration
Assessment
Obstacle factors
Guangxi Zhuang Autonomous Region
