全面护理干预在急诊科患者气管插管非计划性拔管中的应用  

Application of comprehensive nursing intervention in unplanned extubation of tracheal intubation in emergency patients

作　　者：留静[1] 李超男 阙献琴 潘红英[2] LIU Jing;LI Chaonan;QUE Xianqin;PAN Hongying(Department of Emergency,Lishui Central Hospital in Zhejiang Province,Lishui 323000,China;Department of Nursing,Lishui Central Hospital in Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市中心医院急诊科,浙江丽水323000 [2]浙江省丽水市中心医院护理部,浙江丽水323000

出　　处：《中国现代医生》2019年第25期145-148,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2017KY723)

摘　　要：目的研究全面护理干预在急诊科患者气管插管非计划性拔管(unplanned extubation,UEX)中的应用。方法选择2017年9月~2018年8月间在我院急诊科治疗的非计划性拔管患者68例作为研究对象,按照随机数字法分为对照组和观察组,每组34例,观察组应用全面护理干预,对照组应用常规护理,主要通过回顾性分析的方式来分析所有进行非计划性拔管的急诊科患者的临床资料,并且将护理问题进行记录,另外将护理人员所进行的护理工作进行总结,制定合理有效的对策措施。结果观察组护理总有效率为94.12%,明显高于对照组护理总有效率(73.53%),差异有统计学意义(P<0.05),观察组UEX发生率为8.82%,明显低于对照组UEX发生率(38.24%),差异有统计学意义(P<0.05)。观察组护理满意度优于对照组。护理人员对非计划性拔管的急诊科患者进行护理时,可以通过对气管插管进行有效的固定、对镇静药物进行合理使用使用、进行有效的肢体约束、加强护患沟通、加强对资历较低护士的培训及护理操作规范等多种途径来进行相关的护理工作,可以有效的减少气管插管拔除的发生率,大大减少护理纠纷。结论全面护理干预不仅能够降低急诊科非计划性拔管的拔管率,还能显著提高护理满意度,值得在临床推广应用。Objective To study the application of comprehensive nursing intervention in unplanned extubation of tracheal intubation in emergency patients.Methods A total of 68 patients with unplanned extubation who were treated in the department of emergency of our hospital from September 2017 to August 2018 were enrolled in the study.They were divided into control group and observation group according to the random number rule,34 cases in each group.The observation group was given comprehensive nursing intervention,and the control group was given routine nursing.The clinical data of all emergency department patients who underwent unplanned extubation were analyzed by retrospective analysis,and the nursing problems were recorded.The nursing work carried out was summarized and reasonable and effective countermeasures were formulated.Results The total effective rate of observation group was 94.12%,which was significantly higher than that of the control group(73.53%).The difference was statistically significant(P<0.05).The incidence of UEX in the observation group was 8.82%,which was significantly lower than that of the control group(38.24%),and the difference was statistically significant(P<0.05).The nursing satisfaction in observation group was also superior to the control group.The following measures could be taken for the care of patients with unplanned extubation,including effective fixation of tracheal intubation,rational use of sedative drugs,effective limb restraint,enhanced communication between nurses and patients,enhanced training for nurses,and strengthened nursing practices and so on,which could effectively reduce the incidence of tracheal extubation and greatly reduce nursing disputes.Conclusion Comprehensive nursing intervention can not only reduce the rate of extubation of unplanned extubation in the emergency department,but also significantly improve the satisfaction of nursing.It is worthy of clinical application.

关 键 词：急诊科 气管插管 非计划性拔管 护理 

分 类 号：R473.5[医药卫生—护理学]