北京市护理人员对心脏骤停患者目标体温管理的现状调查

doi:10.3761/j.issn.0254-1769.2019.09.018

摘要/Abstract

摘要：

目的调查北京市护理人员对心脏骤停患者目标体温管理的现状。方法采用便利抽样法,采用自行设计的调查问卷调查2017年9月—12月北京市22所医院的急诊科和ICU的护理人员,调查内容包括调查科室和护理人员的一般特征、护理人员对心脏骤停患者目标体温管理的认知及实践。结果共发放900份问卷,791名（87.9%）护理人员完成调查。其中87.1%的护士不知道目标体温管理的概念,84.8%的护士不知道亚低温治疗的概念。仅有6.4%的护理人员表示会对心脏骤停患者进行目标体温管理,32个科室中只有4个科室以及5.7%的护理人员表示对心脏骤停患者实施过亚低温治疗,未实施的主要原因是科室未开展亚低温治疗、对相关知识了解较少。而执行过目标体温管理的护理人员表示,在实施亚低温治疗过程中会更频繁地使用静脉滴注冰盐水和冰袋、冰帽、冰毯来诱导和维持目标体温,而很少使用先进的自粘式体表降温毯和血管内降温技术。结论心脏骤停患者的目标体温管理在中国仍处于应用早期阶段,北京市护理人员对目标体温管理的认知和实践尚不足,需要进一步提升。

关键词: 急诊处理, 目标体温管理, 亚低温, 心脏骤停, 护理人员, 护理管理研究

Abstract:

Objective To investigate the current status of targeted temperature management （TTM） for patients following cardiac arrest（CA） among nurses in Beijing.Methods Using convenience sampling method,791 emergency department and ICU nurses from 22 hospitals in Beijing were investigated from September to December 2017. Self-designed questionnaire was used to collection data on general characteristics of nurses and their cognition and practice of TTM for cardiac arrest patients.Results Totally 791 nurses completed the survey（87.9%）. Among these nurses,87.1% did not know the concept of TTM,84.8% did not know the concept of Therapeutic Hypothermia（TH）. Only 6.4% of the nurses stated that TTM would be conducted in cardiac arrest patients. Only 4 of 32 departments,5.7% of the nurses had implemented TH for cardiac arrest patients. Main reasons for no implementation of TH were absence of TH in department and lack of relevant knowledge. For those had performed TTM,TH was reported to be conducted with using cold intravenous fluid infusion and ice bag,ice cap,and ice blanket more frequently,whereas external advanced surface cooling gel pads and intravascular cooling were rarely used.Conclusion Very few nurses know the TTM concept and only a small number have implemented TTM. The knowledge and practice of TTM among nurses in Beijing are insufficient and needed to be further improved.

Key words: Emergency Treatment, Targeted Temperature Management, Therapeutic Hypothermia, Cardiac Arrest, Nursing Staff, Nursing Administration Research

马莉, 杜兰芳, 马青变, 葛宝兰, 崔曼. 北京市护理人员对心脏骤停患者目标体温管理的现状调查[J]. 中华护理杂志, 2019, 54(9): 1373-1377.

MA Li, DU Lanfang, MA Qingbian, GE Baolan, CUI Man. Current status of targeted temperature management for cardiac arrest patients：a survey of nurses in Beijing[J]. Chinese Journal of Nursing, 2019, 54(9): 1373-1377.

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