新型机械压迫装置的评估。

IF 2.5 4区 医学 Q1 NURSING
American Journal of Nursing Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI:10.1097/01.NAJ.0001081748.24595.eb
Carmen R Davis, Terrie Beeson, Haley M Porter, Karen K Giuliano
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引用次数: 0

摘要

背景:静脉血栓栓塞症(VTE静脉血栓栓塞症(VTE)是导致住院病人死亡的主要可预防原因。目前用于预防 VTE 的外部机械加压的间歇性气动加压(IPC)装置存在许多临床难题,常常导致治疗效果不佳。目的:该质量改进项目旨在比较新型机械加压装置(MCD)和标准 IPC 装置在三个临床住院病房的实际临床使用情况。比较基于以下患者结果测量:佩戴时间评估、最佳佩戴时间的坚持情况、患者舒适度和设备满意度评估以及对移动目标的感知影响。此外,还测量了护士对移动临床可用性的满意度:方法:该项目采用了前后期设计。研究招募了三个临床研究单位的 89 名手术患者和 63 名护理人员。通过电子健康记录、MCD 数据记录、患者调查和护理人员调查收集数据。数据分析采用描述性统计和独立样本 t 检验。在干预前,使用当前的 IPC 设备收集数据。然后对护理人员进行了使用 MCD 的培训。干预后,使用 MCD 代替 IPC 设备:与IPC患者(平均每天12.9小时)相比,MCD患者的佩戴时间明显更长(P≤0.001)(平均每天19.3小时)。与 IPC 患者相比,MCD 患者的睡眠质量明显更好(P = 0.04),腿部出汗的问题也更少(P ≤ 0.001),对移动目标的帮助也更好(P ≤ 0.001)。护理人员报告称,使用MCD后,移动记录的准确性明显提高(P≤0.001),但他们对患者达到移动目标的满意度的看法没有差异:结论:从患者和护士的角度来看,使用 MCD 设备预防 VTE 带来了实际和感知上的改善。虽然这些结果提供了初步数据来支持这一可能很有前景的系统,但还需要更多的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of a Novel Mechanical Compression Device.

Background: Venous thromboembolism (VTE) is a leading preventable cause of death in hospitalized patients. Current intermittent pneumatic compression (IPC) devices used to provide external mechanical compression for VTE prevention are associated with a multitude of clinical challenges that often result in subtherapeutic use. A comparative study was conducted of the real-world clinical use of a novel mechanical compression device (MCD) and a current IPC device.

Purpose: The purpose of this quality improvement project was to compare use of the novel MCD and the standard IPC device on three clinical inpatient hospital units. Comparisons were based on the following patient outcome measures: evaluation of wear time, adherence to optimal wear time, evaluation of both patient comfort and device satisfaction, and perceived impact on mobility goals. Nurses' satisfaction with the clinical usability for mobility was also measured.

Methods: This project used a pre-post design. A convenience sample of 89 surgical patients on the three clinical study units and 63 nursing staff members were recruited for the study. Data were collected using electronic health records, MCD data records, patient surveys, and nursing staff surveys. Data were analyzed using descriptive statistics and independent sample t tests. In the preintervention period, data were collected using the current IPC device. Nursing staff were then trained on use of the MCD. In the postintervention period, the MCDs were used in place of the IPC devices.

Results: MCD patients had significantly longer (P ≤ 0.001) wear time (mean, 19.3 hours/day) compared with IPC patients (mean, 12.9 hours/day). MCD patients also reported significantly better sleep (P = 0.04), fewer problems with sweaty legs (P ≤ 0.001), and improved assistance with mobility goals (P ≤ 0.001) than IPC patients. Nursing staff reported significantly improved accuracy of mobility documentation (P ≤ 0.001) with the MCD, but no differences in their perception of patient satisfaction with meeting mobility goals.

Conclusions: Use of the MCD device for VTE prophylaxis resulted in actual and perceived improvements from the perspective of both patients and nurses. While these results provide initial data in support of a potentially promising system, more research is needed.

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来源期刊
CiteScore
1.10
自引率
3.70%
发文量
604
审稿时长
6-12 weeks
期刊介绍: The American Journal of Nursing is the oldest and most honored broad-based nursing journal in the world. Peer reviewed and evidence-based, it is considered the profession’s premier journal. AJN adheres to journalistic standards that require transparency of real and potential conflicts of interests that authors,editors and reviewers may have. It follows publishing standards set by the International Committee of Medical Journal Editors (ICMJE; www.icmje.org), the World Association of Medical Editors (WAME; www.wame.org), and the Committee on Publication Ethics (COPE; http://publicationethics.org/). AJN welcomes submissions of evidence-based clinical application papers and descriptions of best clinical practices, original research and QI reports, case studies, narratives, commentaries, and other manuscripts on a variety of clinical and professional topics. The journal also welcomes submissions for its various departments and columns, including artwork and poetry that is relevant to nursing or health care. Guidelines on writing for specific departments—Art of Nursing, Viewpoint, Policy and Politics, and Reflections—are available at http://AJN.edmgr.com. AJN''s mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.
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