摘要
目的探讨标准化镇静护理给药方案在ICU机械通气患者镇静治疗中的应用效果。方法将综合性ICU接受机械通气及镇静治疗的患者74例,按入住ICU时间分为干预组和对照组各37例。对照组采用现有给药护理措施,医生在开具镇静处方时给出初始泵速,护士使用Ramsay镇静评分表每4小时对患者进行镇静评估,并根据评估结果及患者表现进行泵速调整。干预组采取标准化镇静护理给药方案,即包括人员培训、标准化表单设计、动态镇静目标设置、规范评估并记录等。比较干预前后两组镇静治疗效果及不良事件发生情况。结果干预后两组镇静评分、住院时间比较,差异有统计学意义(均P<0.05);两组ICU留观时间、置管期间镇静药物使用情况、与镇静有关不良事件发生率比较,差异无统计学意义(均P>0.05)。结论标准化镇静护理给药方案可使患者镇静深度适宜并缩短患者住院时间,对镇静治疗的过程指标及结局指标均有良好改善。
Objective To evaluate the effects of a standard sedation protocol on mechanically ventilated patients in ICU. Methods A total of 74 mechanically ventilated patients in ICU were divided into 2 groups of 37 each according to admission time. The control group were subjected to routine sedation care： doctors prescribed sedatives and initial infusion rates, then nurses made sedation assessment against the Ramsay sedation scale, and adjusted infusion rates according to Ramsay scores and patientsr conditions. The intervention group were assigned to a standard sedation protocol, which included staff training on sedation care, design of standar- dized assessment tables, setting of dynamic sedation goals, standardized assessment and documentation process, etc. The sedation effects and incidence rates of adverse events related to sedation before and after sedation care between the 2 groups were compared. Results After intervention, the sedation scores and lengths of hospital stay between the 2 groups had significant differences （P〈0.05 for both）. There were no statistical differences in the lengths of ICU stay, usage of sedatives, and the incidence rates of adverse events related to sedation between the 2 groups （P〉0.05 for all）. Conclusion Standard sedation protocol could provide an appropriate sedation level, shorten length of hospital stay, and improve both process and outcome indicators of sedation effects.
