中华护理杂志 ›› 2023, Vol. 58 ›› Issue (23): 2864-2872.DOI: 10.3761/j.issn.0254-1769.2023.23.007
仇露露(), 张洪涛, 万薇薇, 林华权, 冉鱼华, 许小明()
收稿日期:
2023-05-29
出版日期:
2023-12-10
发布日期:
2023-12-12
通讯作者:
许小明,E-mail:4609921210@qq.com作者简介:
仇露露:女,本科(硕士在读),护师,E-mail:1565902649@qq.com
基金资助:
QIU Lulu(), ZHANG Hongtao, WAN Weiwei, LIN Huaquan, RAN Yuhua, XU Xiaoming()
Received:
2023-05-29
Online:
2023-12-10
Published:
2023-12-12
摘要:
目的 检索ICU患者呼吸机警报管理的相关证据,并进行最佳证据汇总,以期为ICU患者呼吸机警报管理决策提供参考。 方法 系统检索国内外相关指南网站、专业协会网站以及PubMed、CINAHL、Embase、Web of Science、维普数据库、中国知网、万方数据库等与ICU患者呼吸机警报管理相关的临床决策、指南、系统评价、专家共识以及随机对照试验,检索时限为建库至2023年4月22日。由2名研究者独立对文献进行质量评价与结果提取。 结果 最终纳入14篇文献,其中指南4篇、国际标准2篇、国家标准2篇、专家共识2篇、系统评价3篇、随机对照试验1篇;结合专业人员判断,汇总了27条证据,包括多学科团队合作、警报设置、警报监测与处理、警报管理要求、警报教育培训和呼吸机维护6个方面。 结论 该研究总结了ICU患者呼吸机警报管理的最佳证据,可为护理人员的临床决策提供循证依据,以科学的管理方式解决临床呼吸机警报问题,提升管理质量和管理效率。
仇露露, 张洪涛, 万薇薇, 林华权, 冉鱼华, 许小明. ICU患者呼吸机警报管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(23): 2864-2872.
QIU Lulu, ZHANG Hongtao, WAN Weiwei, LIN Huaquan, RAN Yuhua, XU Xiaoming. Summary of best evidence for ventilator alarm management for ICU patients[J]. Chinese Journal of Nursing, 2023, 58(23): 2864-2872.
[1] | 刘启帆. 重症监护室噪声现状及患者对仪器报警感知的相关研究[D]. 天津: 天津医科大学, 2019. |
Liu QF. Study on noise status in intensive care unit and patients’ perception of instrument alarm[D]. Tianjin: Tianjin Medical University, 2019. | |
[2] |
Korniewicz DM, Clark T, David Y. A national online survey on the effectiveness of clinical alarms[J]. Am J Crit Care, 2008, 17(1):36-41.
PMID |
[3] |
Walsh BK, Waugh JB. Alarm strategies and surveillance for mechanical ventilation[J]. Respir Care, 2020, 65(6):820-831.
DOI PMID |
[4] | ECRI Institute. 2019 top 10 health technology hazards executive brief:a report from health devices[C]. Plymouth Meeting. PA: ECRI Institute, 2018. |
[5] |
Belteki G, Morley CJ. Frequency,duration and cause of ventila-tor alarms on a neonatal intensive care unit[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(4):F307-F311.
DOI URL |
[6] | Harris P, Zegrehemsey J K, Schindler D, et al. Patient charac-teristics associated with false arrhythmia alarms in intensive care[EB/OL].[2022-09-13]. http://pubmed.ncbi.nlm.nih.goo/284-585541/. |
[7] | 冀璇, 毕家驷, 李真, 等. 基于Web of Science的警报疲劳研究的可视化分析[J]. 护理研究, 2019, 33(12):2174-2178. |
Ji X, Bi JS, Li Z, et al. Visualization analysis of research status quo of alarm fatiguebased on Web of Science[J]. Chin Nurs Res, 2019, 33(12):2174-2178. | |
[8] | 尹曾珍, 岳丽青, 李珍, 等. 重症监护室呼吸机警报管理研究进展[J]. 中国护理管理, 2020, 20(2):241-245. |
Yin CZ, Yue LQ, Li Z, et al. Research progress on ventilator alarm management in Intensive Care Unit[J]. Chin Nurs Manag, 2020, 20(2):241-245. | |
[9] |
Stokes JE, Manzoor SH, Cvach MM. Ventilator alarms:challenges and opportunities for improvement[J]. Biomed Instrum Technol, 2017, 51(5):390-397.
DOI URL |
[10] |
许华娇, 吴玲玲, 张琦. ICU患者胰岛素静脉输注管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(12):1489-1495.
DOI URL |
Xu HJ, Wu LL, Zhang Q. Summary of best evidence for the management of insulin intravenous infusion in ICU patients[J]. Chin J Nurs, 2023, 58(12):1489-1495.
DOI URL |
|
[11] |
Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ:advancing guideline development,reporting,and evaluation in health care[J]. Prev Med, 2010, 51(5):421-424.
DOI PMID |
[12] |
郭桂华, 许小明, 王海靓, 等. 脑卒中呼吸系统感染患者气道管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(1):31-38.
DOI URL |
Guo GH, Xu XM, Wang HL, et al. Summary of the best evidence of airway nursingmanagement in patients with respiratory infection after stroke[J]. Chin J Nurs, 2023, 58(1):31-38. | |
[13] |
张奕, 陈香萍, 邵桑, 等. 床旁心电监护仪报警管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(3):445-451.
DOI |
Zhang Y, Chen XP, Shao S, et al. Evidence summary for management of bedside electrocardiogram monitor alarms[J]. Chin J Nurs, 2021, 56(03):445-451. | |
[14] |
Tasaka S, Ohshimo S, Takeuchi M, et al. ARDS clinical prac-tice guideline 2021 committee from the Japanese Society of Intensive Care Medicine,the Japanese Respiratory Society,and the Japanese Society of Respiratory Care Medicine. ARDS clinical practice guideline 2021[J]. J Intensive Care, 2022, 10(1):32.
DOI PMID |
[15] | Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome[J]. BMJ Open Respir Res, 2019, 6(1):e000420. |
[16] | 国家卫生健康委员会. 呼吸机安全管理[EB/OL]. (2020-05-01)[2023-01-11]. https://www.nhc.gov.cn/wjw/s9495/202003/b58664f1dcaf4f349caed80820800c08/files/af323f6cdf0e422d83d2ada43 59e7359.pdf. |
National Health Commission of the People’s Republic of China. Safety management for lung ventilator[EB/OL]. (2020-05-01)[2023-01-11]. https://www.nhc.gov.cn/wjw/s9495/202003/b58664f1dcaf4f349caed80820800c08/files/af323f6cdf0e422d83d2ada43 59e7359.pdf. | |
[17] | 全国医学计量技术委员会. 呼吸机校准规范[EB/OL]. (2018-08-27)[2023-01-10]. http://www.jjg.spc.org.cn/resmea/view/stdonline. |
The National Technical Committee of Medical Metrology. Calibration specification for ventilators[EB/OL]. (2018-08-27)[2023-01-10]. http://www.jjg.spc.org.cn/resmea/view/stdonline. | |
[18] | Emergency Care Research Institute. The alarm safety workbook[EB/OL]. (2014-10-07)[2023-01-10]. https://www.ecri.org/alarm-safety-handbook. |
[19] | The Joint Commission. National patient safety goals effective January 2023 for the critical access hospital program[EB/OL]. (2022-10-27)[2023-01-05]. https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2023/npsg_chapter_cah_jan2023.pdf. |
[20] | The International Organization for Standardization. Medical electrical equipment[EB/OL]. (2020-07)[2023-01-10]. https://www.iso.org/standard/72441.html. |
[21] | The Association for the Advancement of Medical Instrumen-tation. AAMI tackles alarm management standard[EB/OL]. (2021-03-03)[2023-01-11]. https://www.aami.org/docs/default-source/foundation/alarms/bit/2017horizons_tackle_alarm_mgmt_stds.pdf. |
[22] | Le Roux P, Menon DK, Citerio G, et al. Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care:a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine[J]. Neurocrit Care, 2014, 21(Suppl 2):S1-S26. |
[23] | Barbas CS, Isola AM, Farias AM, et al. Brazilian recommendations of mechanical ventilation 2013. Part I[J]. Rev Bras Ter Intensiva, 2014, 26(2):89-121. |
[24] |
Nyarko BA, Nie HY, Yin ZZ, et al. The effect of educational interventions in managing nurses’ alarm fatigue:an integrative review[J]. J Clin Nurs, 2023, 32(13/14):2985-2997.
DOI URL |
[25] |
Yue LQ, Plummer V, Cross W. The effectiveness of nurse education and training for clinical alarm response and management:a systematic review[J]. J Clin Nurs, 2017, 26(17/18):2511-2526.
DOI URL |
[26] |
Lewandowska K, Weisbrot M, Cieloszyk A, et al. Impact of alarm fatigue on the work of nurses in an intensive care environment-a systematic review[J]. Int J Environ Res Public Health, 2020, 17(22):8409.
DOI URL |
[27] |
Bi JS, Yin X, Li HY, et al. Effects of monitor alarm management training on nurses’ alarm fatigue:a randomised controlled trial[J]. J Clin Nurs, 2020, 29(21/22):4203-4216.
DOI URL |
[28] |
Oliveira AEC, Machado AB, Santos EDD, et al. Alarm fatigue and the implications for patient safety[J]. Rev Bras Enferm, 2018, 71(6):3035-3040.
DOI PMID |
[29] | 邓桂元, 李映兰, 岳丽青, 等. 多学科团队合作医疗设备临床警报管理模式的建立与实践[J]. 中国护理管理, 2018, 18(8):1025-1029. |
Deng GY, Li YL, Yue LQ, et al. The establishment and prac-tice of multidisciplinary team cooperation clinical alarm man-agement model for medical device[J]. Chin Nurs Manag, 2018, 18(8):1025-1029. | |
[30] |
Nix M. Combating alarm fatigue[J]. Am J Nurs, 2015, 115(2):16.
DOI PMID |
[31] |
Koomen E, Webster CS, Konrad D, et al. Reducing medical device alarms by an order of magnitude:a human factors approach[J]. Anaesth Intensive Care, 2021, 49(1):52-61.
DOI URL |
[32] | 王婧, 王建宁, 周松, 等. ICU护士医疗设备报警疲劳程度及其影响因素的研究[J]. 中华护理杂志, 2017, 52(2):211-215. |
Wang J, Wang JN, Zhou S, et al. The status and influencing factors of alarm fatigue towards medical devices among ICU nurses[J]. Chin J Nurs, 2017, 52(2):211-215. | |
[33] | Williams LM, Sharma S. Ventilator safety[M]. Treasure Island(FL): StatPearls Publishing, 2023. |
[34] | Reising DVC, Downs JL, Bayn D. Human performance models for response to alarmnotifications in the process industries:an industrial case study[J]. Proc Hum Factors Ergon Soc Annu Meet, 2004, 48(10):1189-1193. |
[35] |
Görges M, Markewitz BA, Westenskow DR. Improving alarm performance in the medical intensive care unit using delays and clinical context[J]. Anesth Analg, 2009, 108(5):1546-1552.
DOI PMID |
[36] |
Ruppel H, Bonafide CP. Sounds good:the bright future of clinical alarm management initiatives[J]. BMJ Qual Saf, 2020, 29(9):701-703.
DOI URL |
[37] | 李明珍, 饶晓华, 张智慧, 等. ICU护士处理医疗设备报警影响因素的质性研究[J]. 护理学杂志, 2020, 35(23):49-51. |
Li MZ, Rao XH, Zhang ZH, et al. The influential factors on bedside management ofmedical equipment alarm among ICU nurses:a qualitative study[J]. J Nurs Sci, 2020, 35(23):49-51. | |
[38] | 杨雪柯. 护理人员对心电监护仪报警知信行的调查研究[D]. 武汉: 华中科技大学, 2019. |
Yang XK. Investigation and study on nurses’ knowledge,attitude and behavior towards ECG monitor alarm[D]. Wuhan: Huazhong University of Science and Technology, 2019. | |
[39] | 徐奕锋. 呼吸机常见故障处理及预防性维护方法探讨[J]. 中国医疗器械信息, 2023, 29(12):172-175. |
Xu YF. Discussion on common troubleshooting and preventive maintenance of ventilator[J]. China Med Device Inf, 2023, 29(12):172-175. | |
[40] | 李凯, 岳昕, 宋强, 等. 呼吸机三级预防性维护保养方案探讨与实践[J]. 中国医疗器械信息, 2023, 29(10):151-154,169. |
Li K, Yue X, Song Q, et al. Discussion and practice of three-level preventive maintenance plan for ventilator[J]. China Med Device Inf, 2023, 29(10):151-154,169. |
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