中华护理杂志 ›› 2023, Vol. 58 ›› Issue (10): 1199-1204.DOI: 10.3761/j.issn.0254-1769.2023.10.007
刘飞跃(
), 邓德贵, 张馨尹, 杨叶, 宋昱莹, 姚惠萍(
)
收稿日期:2022-10-26
出版日期:2023-05-20
发布日期:2023-05-30
*通讯作者:
姚惠萍,E-mail:1390906298@qq.com作者简介:刘飞跃:女,本科(硕士在读),护士,E-mail:2446004283@qq.com
LIU Feiyue(
), DENG Degui, ZHANG Xinyin, YANG Ye, SONG Yuying, YAO Huiping(
)
Received:2022-10-26
Online:2023-05-20
Published:2023-05-30
摘要:
目的 构建俯卧位通气患者安全和舒适护理方案,为俯卧位护理实践提供指导。 方法 通过查阅相关文献,总结现有研究证据,初步构建俯卧位通气患者安全和舒适护理方案。采用2轮德尔菲专家函询法,根据专家意见对方案条目进行修改。 结果 第1轮函询了17名专家,有效问卷回收率为94.12%;第2轮函询了16名专家,有效回收率为93.75%。2轮专家权威系数分别为0.91、0.92,肯德尔和谐系数分别为0.294、0.199(均P<0.001)。第2轮函询,各条目变异系数为0~0.17,重要性评分为4.40~5.00分,最终形成俯卧位通气患者安全和舒适护理方案,包括3个一级指标、11个二级指标、40个三级指标。 结论 该研究构建的俯卧位通气患者安全和舒适护理方案具有科学性、可行性和较强的临床实用价值,能够为临床护理实践提供指导。
刘飞跃, 邓德贵, 张馨尹, 杨叶, 宋昱莹, 姚惠萍. 俯卧位通气患者安全和舒适护理方案的构建[J]. 中华护理杂志, 2023, 58(10): 1199-1204.
LIU Feiyue, DENG Degui, ZHANG Xinyin, YANG Ye, SONG Yuying, YAO Huiping. Construction of a safe and comfortable nursing plan for patients with prone position ventilation[J]. Chinese Journal of Nursing, 2023, 58(10): 1199-1204.
| [1] | Zhan ZY, Cai HR, Cai HL, et al. Effects of 45° prone position ventilation in the treatment of acute respiratory distress syndrome:a protocol for a randomized controlled trial study[J]. Medicine(Baltimore), 2021, 100(19):e25897. |
| [2] |
Petrone P, Brathwaite CEM, Joseph DK. Prone ventilation as treatment of acute respiratory distress syndrome related to COVID-19[J]. Eur J Trauma Emerg Surg, 2021, 47(4):1017-1022.
DOI |
| [3] |
Jahani S, Hajivand Soleymani Z, Asadizaker M, et al. Determination of the effects of prone position on oxygenation in patients with acute respiratory failure under mechanical ventilation in ICU[J]. J Med Life, 2018, 11(4):274-280.
DOI PMID |
| [4] | 陈俊杉, 范杰梅, 余金甜, 等. ICU患者机械通气期间真实体验研究的Meta整合[J]. 中国实用护理杂志, 2020, 36(16):1274-1281. |
| Chen JS, Fan JM, Yu JT, et al. The lived experience of patients with mechanical ventilation in intensive care unit:a Meta-synthesis[J]. Chin J Pract Nurs, 2020, 36(16):1274-1281. | |
| [5] |
Sun L, Hymowitz M, Pomeranz HD. Eye protection for patients with COVID-19 undergoing prolonged prone-position ventilation[J]. JAMA Ophthalmol, 2021, 139(1):109-112.
DOI PMID |
| [6] |
Stubington TJ, Mansuri MS. Novel technique using surgical scrub sponges to protect the nose and face during prone ventilation for coronavirus disease 2019[J]. J Laryngol Otol, 2020, 134(8):735-738.
DOI PMID |
| [7] | 彭小贝, 贺连香, 陈嘉. 急性呼吸窘迫综合征病人仰卧位、俯卧位通气联合振动排痰的疗效比较[J]. 护理研究, 2018, 32(9):1387-1392. |
| Peng XB, He LX, Chen J. Comparison of the curative effect of supine position and prone position ventilation combined with vibration sputum in patients with acute respiratory distress syndrome[J]. Chin Nurs Res, 2018, 32(9):1387-1392. | |
| [8] |
宋淳, 宋才举, 李常霞, 等. 分体式俯卧位通气垫的设计及应用[J]. 中华护理杂志, 2021, 56(9):1431-1434.
DOI URL |
|
Song C, Song CJ, Li CX, et al. Design and application of split prone position air cushion[J]. Chin J Nurs, 2021, 56(9):1431-1434.
DOI URL |
|
| [9] |
Poor AD, Acquah SO, Wells CM, et al. Implementing automated prone ventilation for acute respiratory distress syndrome via simulation-based training[J]. Am J Crit Care, 2020, 29(3):e52-e59.
DOI URL |
| [10] | 郝培育, 李秋萍. ICU护士俯卧位通气知信行现状及影响因素分析[J]. 护理学杂志, 2022, 37(20):84-86. |
| Hao PY, Li QP. Knowledge,attitude,practice towards prone position ventilation among ICU nurses[J]. J Nurs Sci, 2022, 37(20):84-86. | |
| [11] |
Rodríguez-Huerta MD, Díez-Fernández A, Rodríguez-Alonso MJ, et al. Nursing care and prevalence of adverse events in prone position:characteristics of mechanically ventilated patients with severe SARS-CoV-2 pulmonary infection[J]. Nurs Crit Care, 2022, 27(4):493-500.
DOI URL |
| [12] | 韩惠芳, 徐宇红, 岳静燕, 等. 俯卧位不同翻身时间对急性呼吸窘迫综合征机械通气患者的影响[J]. 中华护理杂志, 2013, 48(10):923-925. |
| Han HF, Xu YH, Yue JY, et al. Study on the time of position change in acute respiratory distress syndrome patients treated with prone position mechanical ventilation[J]. Chin J Nurs, 2013, 48(10):923-925. | |
| [13] | 李琳, 李纯, 陈静. 基于肠内营养耐受性评分的俯卧位通气患者早期肠内营养实施[J]. 护理学杂志, 2020, 35(22):11-14. |
| Li L, Li C, Chen J. Practice of administering early enteral nutrition therapy based on enteral nutrition tolerance assessment score to patients receiving mechanical ventilation in the prone position[J]. J Nurs Sci, 2020, 35(22):11-14. | |
| [14] | 周建珍, 张传来, 郑秋兰. 集束化护理对减少ARDS俯卧位通气病人并发症的效果分析[J]. 全科护理, 2017, 15(9):1028-1031. |
| Zhou JZ, Zhang CL, Zheng QL. Analysis of effect of cluster nursing on reducing the complications of patients with ARDS prone position ventilation[J]. Chin Gen Pract Nurs, 2017, 15(9):1028-1031. | |
| [15] |
Moore Z, Patton D, Avsar P, et al. Prevention of pressure ulcers among individuals cared for in the prone position:lessons for the COVID-19 emergency[J]. J Wound Care, 2020, 29(6):312-320.
DOI PMID |
| [16] |
Yu JN, Wu BB, Feng LP, et al. COVID-19 related pressure injuries in patients and personnel:a systematic review[J]. J Tissue Viability, 2021, 30(3):283-290.
DOI URL |
| [17] |
Bruni A, Garofalo E, Grande L, et al. Nursing issues in enteral nutrition during prone position in critically ill patients:a systematic review of the literature[J]. Intensive Crit Care Nurs, 2020, 60:102899.
DOI URL |
| [18] | 袁潇, 杨湘英, 吴清清, 等. 成人急性呼吸窘迫综合征俯卧位机械通气患者压力性损伤预防的最佳证据总结[J]. 中华现代护理杂志, 2021, 27(30):4110-4115. |
| Yuan X, Yang XY, Wu QQ, et al. Best evidence summary for prevention of pressure injury in adult patients with acute respiratory distress syndrome and mechanical ventilation in prone position[J]. Chin J Mod Nurs, 2021, 27(30):4110-4115. | |
| [19] | 蔡凌云, 王雅, 周佳佳, 等. 俯卧位通气重症患者早期肠内营养的证据总结[J]. 中华现代护理杂志, 2022, 28(17):2283-2288. |
| Cai LY, Wang Y, Zhou JJ, et al. Evidence summary of early enteral nutrition in critically ill patients with prone position ventilation[J]. Chin J Mod Nurs, 2022, 28(17):2283-2288. | |
| [20] | 张倩倩, 郭爱敏, 李尊柱, 等. 基于SSKIN集束化方案的俯卧位通气患者面部压力性损伤护理方案的构建[J]. 中华现代护理杂志, 2022, 28(13):1747-1752. |
| Zhang QQ, Guo AM, Li ZZ, et al. Construction of nursing scheme for facial pressure injury of patients with prone position ventilation based on SSKIN cluster scheme[J]. Chin J Mod Nurs, 2022, 28(13):1747-1752. | |
| [21] | 中华医学会重症医学分会重症呼吸学组. 急性呼吸窘迫综合征患者俯卧位通气治疗规范化流程[J]. 中华内科杂志, 2020, 59(10):781-787. |
| Subgroup of Critical Respiratory Diseases,Chinese Society of Critical Care Medicine, Chinese Medical Association. Standardized protocol of prone position ventilation in patients with acute respiratory distress syndrome[J]. Chin J Intern Med, 2020, 59(10):781-787. | |
| [22] | 中国医师协会呼吸医师分会危重症专业委员会, 中华医学会呼吸病学分会危重症医学学组,《中国呼吸危重症疾病营养支持治疗专家共识》专家委员会. 中国呼吸危重症患者营养支持治疗专家共识[J]. 中华医学杂志, 2020, 100(8):573-585. |
| The Critical Illness Professional Committee of the Respiratory Branch of the Chinese Medical Association, the Critical Illness Medical Group of the Respiratory Branch of the Chinese Medical Association,and the Expert Committee of the Expert Consensus on Nutrition Support and Treatment of Respiratory Critical Illness in China. Expert consensus on nutritional support therapy for critically ill respiratory patients in China[J]. Natl Med J China, 2020, 100(8):573-585. | |
| [23] | 中国老年医学学会烧创伤分会, 中华医学会烧伤外科学分会重症学组. 成人烧伤俯卧位治疗全国专家共识(2022版)[J]. 中华烧伤与创面修复杂志, 2022, 38(7):601-609. |
| The Burn and Trauma Branch of Chinese Geriatrics Society,Critical Care Group of Chinese Burn Association. National expert consensus on prone position therapy in adult burn patients(2022 version)[J]. Chin J Burns Wounds, 2022, 38(7):601-609. | |
| [24] | 吕红, 冯萍. 1例危重型新型冠状病毒肺炎患者应用“糖果翻身法”行俯卧位通气治疗的护理[J]. 中华护理杂志, 2020, 55(增刊2):660-662. |
| Lü H, Feng P. A case of severe novel coronavirus pneumonia in prone position with “candy turning method” nursing of ventilation treatment[J]. Chin J Nurs, 2020, 55(z2):660-662. | |
| [25] | 项丽君, 曹猛, 宋学梅, 等. 吸痰时咳嗽强度对气囊压力不达标的预测价值[J]. 解放军护理杂志, 2022, 39(2):46-50. |
| Xiang LJ, Cao M, Song XM, et al. Predictive value of cough strength during sputum suction on substandard cuff pressure[J]. Nurs J Chin PLA, 2022, 39(2):46-50. | |
| [26] |
金静芬, 李梅, 陈圆圆, 等. 脑卒中患者早期运动康复护理方案的构建[J]. 中华护理杂志, 2020, 55(9):1360-1365.
DOI URL |
|
Jin JF, Li M, Chen YY, et al. Construction of early motor rehabilitation nursing program based on Modified Barthel Index grading for stroke patients[J]. Chin J Nurs, 2020, 55(9):1360-1365.
DOI URL |
|
| [27] | 李静怡, 张玉侠, 蒋进军, 等. 有创机械通气患者俯卧位实施方案的构建[J]. 中国护理管理, 2022, 22(1):52-57. |
| Li JY, Zhang YX, Jiang JJ, et al. Construction of prone position ventilation scheme in patients using invasive mechanical ventilation[J]. Chin Nurs Manag, 2022, 22(1):52-57. |
| [1] | 中华护理学会静脉输液治疗专业委员会, 北京护理学会, (执笔:李佳, 李旭英, 覃惠英, 陈利芬, 吴珍明, 胡泽吟, 罗梦娜, 范育英, 吴嘉慧, 林宇萍, 王蕾, 孙文彦, 冯毕龙, 高伟, 李亚南, 侯罗娅, 李春燕. 中心静脉通路装置拔除护理专家共识[J]. 中华护理杂志, 2026, 61(9): 1157-1162. |
| [2] | 周霞, 马艳艳, 师正坤, 于海霞, 周艳, 胡红玲, 李莜, 陈思思, 张京慧. 隧道式经股静脉PICC置入术在困难静脉通路婴幼儿中的应用研究[J]. 中华护理杂志, 2026, 61(9): 1163-1170. |
| [3] | 黄萍, 李黎, 郭骊莉, 徐莹, 叶赟, 江淑芳. 与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用[J]. 中华护理杂志, 2026, 61(9): 1171-1179. |
| [4] | 李佳, 张玉玲, 邢乐, 张利峰, 牛秀峰, 许莉. 早产儿经上肢置入PICC尖端继发性异位风险预测模型的建立与验证[J]. 中华护理杂志, 2026, 61(9): 1180-1186. |
| [5] | 何娟, 赵蕾蕾, 叶冠军, 余艳芬, 傅晓君, 周琴. 1例双侧无名静脉及上腔静脉人工血管置换术后患者经上肢置入PICC的护理[J]. 中华护理杂志, 2026, 61(9): 1187-1191. |
| [6] | 梁江淑渊, 曾妃, 何鹏, 谢梦珊, 江悦, 蒋宗恒, 王建茗. 静脉-静脉体外膜肺氧合患者早期活动风险等级评估系统的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1192-1199. |
| [7] | 陈晨, 顾肖, 郭凡, 王敏, 倪兴梅, 黄琴, 程念开. 3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值[J]. 中华护理杂志, 2026, 61(9): 1200-1207. |
| [8] | 郑煜琳, 刘晋宁, 张静, 郭会敏, 谷艳梅, 张莉莉. 酒精性肝病患者肝移植术后再饮酒现状及其影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1208-1214. |
| [9] | 叶俊霜, 沈丽佳, 孟霞靓, 张玉姣, 蔡根莲, 邵碧云, 周亚辉, 张柳倩, 应金萍. 维持性血液透析患者对口腔衰弱认知和体验的质性研究[J]. 中华护理杂志, 2026, 61(9): 1215-1220. |
| [10] | 王芸姣, 杨玉金, 郑春艳, 彭菲津, 王淑贞, 蒋喜露, 周为民, 王薇, 张娜. 糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1221-1229. |
| [11] | 杨明霞, 安冉, 臧金凤, 李春梅. 老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析[J]. 中华护理杂志, 2026, 61(9): 1230-1236. |
| [12] | 梁和静, 许鹊, 史云霞, 祖金美, 黄文静, 杨春旭, 郭明华, 王磊. 颈动脉内膜剥脱术围手术期护理质量评价指标的构建[J]. 中华护理杂志, 2026, 61(9): 1237-1244. |
| [13] | 韩媛媛, 石玉竹, 尚文涵, 么莉. 870所三级甲等医院老年住院患者跌倒伤害发生现状与影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1245-1252. |
| [14] | 夏云芳, 王洪, 崔岱, 付真真, 朱敏. 1例弥漫性毒性甲状腺肿合并超敏反应综合征青少年患者的护理[J]. 中华护理杂志, 2026, 61(9): 1253-1256. |
| [15] | 周益飞, 王海苹, 胡益环, 应莉, 罗松娜. 1例氢氟酸中毒并发呼吸心搏骤停患者的急救护理[J]. 中华护理杂志, 2026, 61(9): 1257-1260. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||