摘要
目的探讨优化癫痫持续状态患者入室后首次给予抗癫痫药物(AED)护理流程的应用效果。方法采用类实验研究方便抽样,选择入住三甲医院神经内科ICU 88例患者为研究对象,其中2016年1月至2017年12月收治的44例重症癫痫持续状态患者为对照组,选择2018年1月至2019年12月收治的44例重症癫痫持续状态患者为试验组,试验组在入室后实施优化后的首次给药流程,对照组实施常规给药流程。比较两组患者入室后首次给予AED的时间、给药步骤用时、负荷剂量AED储备、不同时间段癫痫发作控制情况等差异性。结果入室后首次给予AED的时间,对照组中位数(四分位数)为31.0(10.0,69.0)min,大于试验组的25.0(16.0,31.8)min,差异有统计学意义(χ^(2)值为-2.760,P<0.05);给药各步骤用时对比:步骤1(患者入室—医嘱确认)的用时比较,差异有统计学意义(χ^(2)值为-2.811,P<0.05);步骤2(医嘱确认—摆药完成)的用时比较,对照组大于试验组,差异有统计学意义(χ^(2)值为-4.327,P<0.05);步骤3(摆药完成—给药完成)用时比较,差异无统计学意义(χ^(2)值为-1.137,P>0.05);对照组负荷剂量AED储备率为63.6%(28/44),试验组为100.0%(44/44),差异有统计学意义(χ^(2)值为19.556,P<0.05);2组患者癫痫控制情况:试验组在首次给药后总控制率为93.2%(41/44),明显高于对照组的61.4%(27/44),差异有统计学意义(Z值为-3.445,P<0.001)。结论通过优化癫痫持续状态患者入室后首次的给药流程,明显缩短了入室后首次给予AED的用时,使患者的临床症状得到改善。
Objective To explore the application effect of optimizing the anti-epileptic drug(AED)administration nursing procedure for patients with severe epilepsy at the first time after ICU admission.Methods A quasi-experiment study was conducted by convenience sampling.The 44 patients with severe status epilepticus admitted in our department from January 2016 to December 2017 were selected as the control group.The 44 patients with status epilepticus admitted in our department from January 2018 to December 2019 were selected as the experimental group.The experimental group was implemented the optimized administration procedure after ICU admission.The control group was implemented the routine administration procedure after ICU admission.Some data of the two groups were compared,including baseline data,first administration time after admission,administration step time,AED dose reserve,and seizures at different time periods and so on.Results Comparative analysis of the time of the first drug administration after admission into the two groups.The administration time of the control group was 31.0(10.0-69.0)min,which was significantly longer than that of the experimental group,25.0(16.0-31.8)min(χ^(2) value was-2.760,P<0.05).Comparison and analysis of the time taken for each step of drug administration:The time taken for step 1(Patient admission—medical order confirmation)in the control group was significantly greater than that in the experimental group(χ^(2) value was-2.811,P<0.05);step 2(medical order confirmation—Prepare medicines)in the control group was significantly greater than that in the experimental group(χ^(2) value was-4.327,P<0.05).There was no significant difference in the time taken for step 3(Prepare medicines—Drug delivery to complete)between the two groups(χ^(2) value was-1.137,P>0.05).Control group AED reserve ratio 63.6%(28/44),experimental group AED reserve was 100.0%(44/44),and the difference was statistically significant(χ^(2) value was 19.556,P<0.05).Epilepsy control in two groups of patients:the total control rate after the first administration of the experimental group was 93.2%(41/44),which was significantly higher than 61.4%(27/44)of the control group(Z value was-3.445,P<0.001).Conclusion It can shorten the time to first give AED and improve the patient's clinical symptoms that optimizing the first drug administration procedure for patients with status epilepticus after admission.
作者
张未迟
龚立超
刘芳
Zhang Weichi;Gong Lichao;Liu Fang(Neurology Department,Xuanwu Hospital Capital Medical University,Beijing 100053,China)
出处
《中国实用护理杂志》
2021年第12期930-935,共6页
Chinese Journal of Practical Nursing
关键词
优化流程
给药时间
癫痫持续状态
有效性
对比研究
Optimization procedure
Time of drug administration
Status epilepticus
Effectiveness
Comparative study
