基于循证的ICU机械通气病人目标导向早期活动方案的构建  

Construction of evidence⁃based goal⁃directed early mobilization program for patients with mechanical ventilation in ICU

作　　者：陈蒿 罗旋 余培琳 余梦婷 李世杰 张婉竹 米洁[1] CHEN Hao;LUO Xuan;YU Peilin;YU Mengting;LI Shijie;ZHANG Wanzhu;MI Jie(The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016 China)

机构地区：[1]重庆医科大学附属第一医院,重庆400016

出　　处：《护理研究》2024年第18期3209-3217,共9页Chinese Nursing Research

基　　金：重庆市科技局项目,编号:cstc2019jscx-msxmX0277。

摘　　要：目的:构建基于循证的重症监护室(ICU)机械通气病人目标导向早期活动方案。方法:基于循证的方法,以目标导向为理论基础,形成ICU机械通气病人目标导向早期活动方案初稿,通过德尔菲法对初稿进行修订,最终形成ICU机械通气病人目标导向早期活动方案。结果:形成了包括早期活动原则、早期活动前准备、早期活动的评估、早期活动的实施、早期活动安全标准及早期活动效果评价指标6项一级指标的ICU机械通气病人目标导向早期活动方案,2轮专家函询问卷回收率分别为95.0%和100.0%,专家权威系数分别为0.94和0.96,变异系数均为0.00~0.11,指标重要性及可操作性的肯德尔和谐系数检验均P<0.001。结论:构建的ICU机械通气病人目标导向早期活动方案具有较好的科学性、可操作性,可为医务人员针对ICU机械通气病人开展早期活动提供参考。Objective:To construct evidence-based goal-directed early mobilization program for patients with mechanical ventilation in intensive care unit(ICU).Methods:Based on evidence⁃based methods and with goal⁃directed as the theoretical foundation,the preliminary evidence-based goal-directed early mobilization program for patients with mechanical ventilation in ICU was formed.Then the preliminary was revised by Delphi method,and evidence⁃based goal⁃directed early mobilization program for patients with mechanical ventilation in ICU was formed.Results:Evidence⁃based goal⁃directed early mobilization program for patients with mechanical ventilation in ICU was formed,which included 6 first⁃level indicators,namely,early activity principles,early activity preparation,early activity evaluation,early activity implementation,early activity safety standards,and early activity effectiveness evaluation.The response rates of the 2 rounds of expert inquiry questionnaires were 95.0%and 100.0%,respectively.The expert authority coefficients were 0.94 and 0.96,respectively.And the coefficient of variation were both ranged from 0.00 to 0.11.The Kendall coefficient of concordance tests for the importance and operability of the indicators were all P<0.001.Conclusions:The evidence⁃based goal⁃directed early mobilization program for patients with mechanical ventilation in ICU constructed in this study has good scientificity and operability,and can provide reference for medical personnel to carry out early mobilization for patients with mechanical ventilation in ICU.

关 键 词：循证护理 重症监护室(ICU) 机械通气 目标导向 早期活动 德尔菲法 

分 类 号：R473[医药卫生—护理学]