前馈控制降低ICU气管插管患者非计划性拔管  

Effect of a feedforward control program in management of unplanned endotracheal extubation(UEE)in ICU patients

作　　者：丁留敏 张秀敏[2] 刘维丽 欧阳蓓蕾[4] 李萍[2] Ding Liumin Zhang Xiumin Li Weili Oyang Beilei(Nursing School, Xinjiang Medical University, Ururnqi 830000, Chin)

机构地区：[1]新疆医科大学护理学院,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院 [3]伊犁州友谊医院重症医学科 [4]阿克苏地区第一人民医院重症医学科

出　　处：《护理学杂志》2017年第3期58-61,共4页Journal of Nursing Science

基　　金：新疆维吾尔自治区人民医院院内项目(20150403)

摘　　要：目的探讨前馈控制降低ICU气管插管患者非计划性拔管的效果。方法对ICU气管插管患者,实施前馈控制干预方案,主要包含成立ICU气管插管患者非计划性拔管的前馈控制管理监督委员会、建立严格的气管插管非计划性拔管风险评估模式(基于SBAR沟通程序的导管交接班流程)、转变护理人员对气管插管非计划性拔管风险管理的理念、加强各能级护理人员相关护理知识及应急技能的培训。结果实施前馈控制后ICU气管插管非计划性拔管发生率由实施前的1.66%降到0.58%;护理人员非计划性拔管相关知识认知、评估技巧(工具)方面及护理对策方面的得分显著高于实施前(均P<0.01)。结论前馈控制用于ICU气管插管非计划性拔管管理,能够有效降低气管插管非计划性拔管的发生率,提高ICU医疗护理质量,保障住院患者的医疗护理安全。Objective To investigate the effect of feedforward control in management of unplanned endotracheal extubation （UEH） in ICU patients. Methods A feedforward control supervision and management committee was built to run a feedforward comtrol program for ICU endotraeheal intubation patients. Measures included establishing a strict unplanned UEE risk assessment model based on the SBAR communication tool for catheter/tube handover, changing nurses＇ conception of UEE risk management, and strength ening training of UEE related knowledge to different levels of nurses. Results After the feedforward control program, the incidence rate of UEE dropped from 1.66% before the program to 0.58%;nurses＇ knowledge of UEE related knowledge, assessment skills （tools）, and nursing strategies were significantly higher than before （P〈0.01 for all）. Conclusion Feedforward control program can reduce the incidence rate of UEE in ICU patients, improve the quality of ICU medical care, and ensure patient safely.

关 键 词：ICU 气管插管 非计划性拔管 前馈控制 

分 类 号：R47[医药卫生—护理学] C931.3[医药卫生—临床医学]