气管插管非计划性拔管预警及决策支持系统的研发与应用  

Development and application of early warning and decision support system for unplanned endotracheal extubation

作　　者：向洋 倪崴莲 XIANG Yang;NI Weilian

机构地区：[1]天津市人工细胞重点实验室/天津市肝胆疾病研究所/卫生部人工细胞工程技术研究中心/天津市第三中心医院重症医学科,300170

出　　处：《中华护理杂志》2022年第1期61-65,共5页Chinese Journal of Nursing

摘　　要：目的研发针对经口气管插管患者的气管插管非计划性拔管(unplanned endotracheal extubation,UEE)预警及决策支持系统,并评价其应用效果。方法组建研发小组,构建UEE预警及决策支持系统,包括评估、预警、决策3个模块。2020年9月在天津市某三级甲等医院ICU中应用,比较系统应用后(2020年9月—2021年3月)与应用前(2020年3月—8月)UEE预防措施执行率、UEE发生率,收集ICU护士对该系统的满意度。结果应用UEE预警及决策支持系统后,UEE预防措施执行率有所提高,在风险评估、气管插管固定、镇痛镇静观察、规范约束方面与系统应用前比较,差异均具有统计学意义(P<0.05);系统应用前后均未发生UEE;ICU护士对该系统的满意度评分为(91.20±7.44)分,处于较高水平。结论UEE预警及决策支持系统能够辅助ICU护士科学开展UEE预防,提高UEE预防措施执行率,保障患者安全。Objective To develop an intelligent early warning and decision support system for the prevention of unplanned endotracheal extubation(UEE)in adults,so as to prevent the occurrence of extubation events and ensure the safety of patients.Methods A system research and development team was set up to build a UEE early warning and decision support system with 3 modules,including evaluation,early warning,and decision-making.It was applied in the ICU of a tertiary A hospital in Tianjin in September 2020.The researchers compared the implementation rate of UEE preventive measures,the incidence rate of UEE,and the satisfaction of ICU nurses with the system before the application(March-August 2020)and after the application(September 2020-March 2021).Results Compared with the system before application,the implementation of UEE preventive measures by ICU nurses was significantly improved,including risk assessment,endotracheal intubation and fixation,analgesia and sedation observation,norms and constraints,and the differences are statistically significant(P<0.05).No UEE occurred before and after system application.The satisfaction score of ICU nurses on the system is(91.20±7.44)points,which is at a high level.Conclusion The UEE early warning and decision support system can assist ICU nurses to scientifically carry out UEE prevention,improve the implementation rate of UEE preventive measures,and ensure patient safety.

关 键 词：经口气管插管 非计划性拔管 风险评估 预警 临床决策 信息系统 护理 

分 类 号：R472[医药卫生—护理学]