背景:越来越多的研究表明,俯卧位通气可以显着改善大多数急性呼吸窘迫综合征(ARDS)患者(70-80%)的氧合指数和血氧饱和度。研究还表明,清醒俯卧位既安全又有效,可以帮助2019年冠状病毒病(COVID-19)患者自主呼吸。然而,在治疗因其他原因导致的COVID-19或ARDS患者时,俯卧位并未被广泛采用。基础知识,积极的态度,护理人员的正确做法对于增加俯卧位的使用是必要的,减少与俯卧位相关的并发症的发生率,提高医疗质量和安全性。
目的:本研究旨在调查知识,态度,以及在COVID-19病房工作的重症监护病房(ICU)护士中患者倾向定位的实践,并提供改进建议。
方法:从上海两家指定的三级医院招募ICU护士进行COVID-19治疗,中国,2022年4月,采用便利采样。以知识维度为重点的问卷调查,态度,和42项俯卧位的练习,进行了。
结果:共有132名ICU护士参加。总体问卷和知识维度的得分,态度,俯卧位为167.28(95%CI,161.70-172.86),78.35(95%CI,76.04-80.66),32.08(95%CI,31.51-32.65),和56.85(95%CI,52.42-61.28)。总体平均得分为79.66%(95%CI,0.77-0.82)。多元线性回归分析结果显示,COVID-19患者既往治疗经验和职称与知识水平相关,态度,和俯卧位的练习。
结论:ICU护士坚信俯卧位的有效性,但是他们的知识和实践水平需要提高。COVID-19患者的治疗经验和职称与知识水平有关,态度,和俯卧位的练习。护理管理者应确保ICU护士在俯卧定位方面受过良好的培训,并帮助提高对俯卧定位的知识和态度,以促进其广泛使用。
结论:需要制定临床指南和在职培训模块,以促进俯卧位的使用并减少俯卧位相关并发症。
An increasing number of studies persistently demonstrate that prone position ventilation can significantly improve the oxygenation index and blood oxygen saturation for most patients (70-80%) with acute respiratory distress syndrome (ARDS). Studies have also shown that the awake prone position was both safe and effective in helping patients with coronavirus disease 2019 (COVID-19) breathe spontaneously. However, the prone position is not widely adopted when treating patients with COVID-19 or ARDS from other causes. Basic knowledge, positive attitudes, and correct practices among the nursing staff are necessary to increase the use of prone positions, reduce the incidence of complications associated with prone positions, and improve the quality and safety of health care.
This study aimed to investigate the knowledge, attitudes, and practice of prone positioning of patients among intensive care unit (ICU) nurses working in COVID-19 units and provide suggestions for improvement.
ICU nurses were recruited from two designated tertiary hospitals for COVID-19 treatment in Shanghai, China, in April 2022, using convenience sampling. A questionnaire survey focusing on the dimensions of knowledge, attitudes, and practice of the prone position with 42 items, was conducted.
A total of 132 ICU nurses participated. The scores on the overall questionnaire and the dimensions of knowledge, attitudes, and practice of prone position were 167.28 (95% CI, 161.70-172.86), 78.35 (95% CI, 76.04-80.66), 32.08 (95% CI, 31.51-32.65), and 56.85 (95% CI, 52.42-61.28) respectively. The overall average score was 79.66% (95% CI, 0.77-0.82). The results of multiple linear regression analysis showed that prior experience in treating patients with COVID-19 and professional titles were related to the level of knowledge, attitudes, and practice of prone position.
The ICU nurses strongly believed in the effectiveness of prone positioning, but their knowledge and practice levels need improvement. The experience in treating patients with COVID-19 and professional titles were related to the level of knowledge, attitudes, and practice of prone position. Nursing managers should ensure that ICU nurses are well trained in prone positioning and help enhance the knowledge and attitudes toward prone positioning to promote its widespread use.
Clinical guidelines and in-service training modules need to be developed to promote the use of prone positioning and reduce prone position-related complications.