ICU 跨学科团队成员对镇静剂的看法:一项调查研究。

Mikita Fuchita, Caitlin Blaine, Alexis Keyworth, Kathryn Morfin, Blake Primi, Kyle Ridgeway, Nikki Stake, Helen Watson, Dan Matlock, Anuj B Mehta
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引用次数: 0

摘要

目的探讨跨学科团队成员在重症监护室护理机械通气患者时对镇静剂的信念和态度:横断面调查:科罗拉多州一家三级医疗学术医院的 17 张病床的心胸重症监护病房:所有在心胸重症监护室工作的护士、医生、高级医师 (APP)、呼吸治疗师、物理治疗师 (PT) 和职业治疗师 (OT):测量和主要结果我们对经过验证的调查工具进行了修改,以评估 ICU 跨学科团队成员对镇静剂的看法。我们以匿名方式收集了 111 名成员的调查回复(回复率为 81%)。受访者以女性为主(70 [63%])。大多数跨学科受访者(94%)认为,他们的镇静实践对患者的预后起到了作用。与医生(19%)和 PTs/OTs (0%)相比,更多的护士(48%)、APPs(62%)和呼吸治疗师(50%)认为镇静有助于减轻患者在呼吸机上承受的心理压力(P = 0.008)。不同学科的受访者倾向于在自己接受机械通气的情况下使用镇静剂的比例差异很大:呼吸治疗师(88%)、护士(83%)、APPs(54%)、PTs/OTs(38%)和医生(19%)(p < 0.001)。在我们的探索性分析中,教育播客的听众比非听众的信念和态度更符合最佳循证实践:我们发现在重症监护室使用镇静剂的信念和态度方面存在明显的跨学科差异。由于 ICU 团队的所有成员都参与了 ICU 中机械通气患者的管理,因此调整镇静的心理模式对于加强跨专业合作和促进镇静最佳实践可能至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perspectives on Sedation Among Interdisciplinary Team Members in ICU: A Survey Study.

Objective: To explore the interdisciplinary team members' beliefs and attitudes about sedation when caring for mechanically ventilated patients in the ICU.

Design: Cross-sectional survey.

Setting: A 17-bed cardiothoracic ICU at a tertiary care academic hospital in Colorado.

Subjects: All nurses, physicians, advanced practice providers (APPs), respiratory therapists, physical therapists (PTs), and occupational therapists (OTs) who work in the cardiothoracic ICU.

Interventions: None.

Measurements and main results: We modified a validated survey instrument to evaluate perspectives on sedation across members of the interdisciplinary ICU team. Survey responses were collected anonymously from 111 members (81% response rate). Respondents were predominantly female (70 [63%]). Most respondents across disciplines (94%) believed that their sedation practice made a difference in patients' outcomes. More nurses (48%), APPs (62%), and respiratory therapists (50%) believed that sedation could help alleviate the psychologic stress that patients experience on the ventilator than physicians (19%) and PTs/OTs (0%) (p = 0.008). The proportion of respondents who preferred to be sedated if they were mechanically ventilated themselves varied widely by discipline: respiratory therapists (88%), nurses (83%), APPs (54%), PTs/OTs (38%), and physicians (19%) (p < 0.001). In our exploratory analysis, listeners of an educational podcast had beliefs and attitudes more aligned with best evidence-based practices than nonlisteners.

Conclusions: We discovered significant interdisciplinary differences in the beliefs and attitudes regarding sedation use in the ICU. Since all ICU team members are involved in managing mechanically ventilated patients in the ICU, aligning the mental models of sedation may be essential to enhance interprofessional collaboration and promote sedation best practices.

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