最近的报告发现,在住院的冠状病毒疾病2019患者中,30%需要ICU护理。了解ICU资源需求仍然是满足重症冠状病毒疾病2019患者当前和预计需求的重要组成部分。
这项研究询问了美国ICU临床医生对管理2019年冠状病毒疾病患者的挑战性护理方面的看法。当前和预期的资源需求,和个人压力。
使用描述性调查方法,我们于2020年4月7日至2020年4月22日进行了一项匿名网络调查(电子邮件和时事通讯),以查询美国国家重症监护组织成员.
通过16项描述性问卷,ICU临床医生对管理严重急性呼吸系统综合症冠状病毒2感染患者的当前和新出现的关键ICU需求的看法进行了评估。资源水平,担心接触严重急性呼吸道综合症冠状病毒2,以及个人压力的感知水平。共有9120名ICU临床医生对调查做出了回应,代表美国所有50个州,4106人(56.9%)在2019年冠状病毒病例超过20,000例的州工作。显示其职业的7,317名受访者包括ICU护士(n=6,731,91.3%),高级执业提供者(执业护士和医师助理;n=334,4.5%),医生(n=212,2.9%),呼吸治疗师(n=31,0.4%),和药剂师(n=30,0.4%)。大多数(n=6,510,88%)报告曾照顾过2019年疑似或确诊冠状病毒疾病的患者。ICU最关键的需求是个人防护设备,特别是N95呼吸器的可用性,ICU人员配置。最大限度地减少医护人员在护理期间的病毒暴露被认为是2019年冠状病毒疾病患者护理最具挑战性的方面(n=2,323,30.9%)。护士报告说,高度关注家庭成员暴露于严重急性呼吸道综合症冠状病毒2(0-10量表的中位数为10分)。同样,在为2019年冠状病毒病患者提供护理的ICU临床医师中,关注水平达到最高10分.
这项全国ICU临床医生调查确定了有关个人防护装备用品的持续担忧,主要问题是N95呼吸器的可用性。随着流行病的继续,ICU临床医生预计可能影响ICU护理的一些有限资源,包括人员,容量,和浪涌电位,以及工作人员和随后的家庭成员接触严重急性呼吸道综合症冠状病毒2。这些持续的担忧极大地放大了个人压力,为专业组织和设施干预工作提供治疗目标。
Recent
reports identify that among hospitalized coronavirus disease 2019 patients, 30% require ICU care. Understanding ICU resource needs remains an essential component of meeting current and projected needs of critically ill coronavirus disease 2019 patients.
This study queried U.S. ICU clinician perspectives on challenging aspects of care in managing coronavirus disease 2019 patients, current and anticipated resource demands, and personal stress.
Using a descriptive survey methodology, an anonymous web-based survey was administered from April 7, 2020, to April 22, 2020 (email and newsletter) to query members of U.S. national critical care organizations.
Through a 16-item descriptive questionnaire, ICU clinician perceptions were assessed regarding current and emerging critical ICU needs in managing the severe acute respiratory syndrome coronavirus 2 infected patients, resource levels, concerns about being exposed to severe acute respiratory syndrome coronavirus 2, and perceived level of personal stress. A total of 9,120 ICU clinicians responded to the survey, representing all 50 U.S. states, with 4,106 (56.9%) working in states with 20,000 or more coronavirus disease 2019 cases. The 7,317 respondents who indicated their profession included ICU nurses (n = 6,731, 91.3%), advanced practice providers (nurse practitioners and physician assistants; n = 334, 4.5%), physicians (n = 212, 2.9%), respiratory therapists (n = 31, 0.4%), and pharmacists (n = 30, 0.4%). A majority (n = 6,510, 88%) reported having cared for a patient with presumed or confirmed coronavirus disease 2019. The most critical ICU needs identified were personal protective equipment, specifically N95 respirator availability, and ICU staffing. Minimizing healthcare worker virus exposure during care was believed to be the most challenging aspect of coronavirus disease 2019 patient care (n = 2,323, 30.9%). Nurses report a high level of concern about exposing family members to severe acute respiratory syndrome coronavirus 2 (median score of 10 on 0-10 scale). Similarly, the level of concern reached the maximum score of 10 in ICU clinicians who had provided care to coronavirus disease 2019 patients.
This national ICU clinician survey identifies continued concerns regarding personal protective equipment supplies with the chief issue being N95 respirator availability. As the pandemic continues, ICU clinicians anticipate a number of limited resources that may impact ICU care including personnel, capacity, and surge potential, as well as staff and subsequent family members exposure to severe acute respiratory syndrome coronavirus 2. These persistent concerns greatly magnify personal stress, offering a therapeutic target for professional organization and facility intervention efforts.