儿童重症监护病房护士主导的机械通气患儿镇痛镇静方案构建  

Construction of Pediatric Intensive Care Unit Nurse-Led Analgesia and Sedation Scheme for Children with Mechanical Ventilation

作　　者：王永霞 徐金梅[1] 翟秀玲 高梅 徐望宁 Wang Yongxia;Xu Jinmei;Zhai Xiuling;Gao Mei;Xu Wangning(Pediatric Intensive Care Unit,Affiliated Hospital of Yangzhou University,Yangzhou 225001,Jiangsu Province,China)

机构地区：[1]扬州大学附属医院儿童重症监护病房,江苏扬州225001

出　　处：《中国社区医师》2024年第31期137-139,共3页Chinese Community Doctors

基　　金：2022年扬州市护理学会软科学研究培育课题(编号:202215)。

摘　　要：目的:构建儿童重症监护病房(PICU)护士主导的机械通气患儿镇痛镇静方案。方法:以《中国儿童重症监护病房镇痛和镇静治疗专家共识》中的相关内容为指导,结合已有研究成果,组建由5名儿童重症监护领域专家学者构成的专家小组,进行半结构式访谈,编制PICU护士主导的用于机械通气患儿的镇痛镇静方案初稿,对20名专家开展2轮德尔菲专家函询,基于肯德尔和谐系数(Kendall'sW)与专家权威系数(Cr)等指标的分析,确定最终管理方案。结果:第1轮专家判断依据(Ca)为0.895,熟悉程度(Cs)为0.888,Cr为0.892;第2轮Ca为0.934,Cs为0.896,Cr为0.915。2轮专家函询的Kendall'sW分别为0.337、0.412,最终版本方案涵盖5个一级指标、14个二级指标,条目重要性评分均>4分,变异系数<0.20。结论:本研究构建的PICU护士主导的机械通气患儿镇痛镇静方案具有科学性,可以更好地发挥护士主观能动性,提高管理质量。Objective:To construct analgesia and sedation scheme led by pediatric intensive care unit(PICU)nurse for children with mechanical ventilation.Methods:Based on the relevant contents of the"Expert Consensus on Analgesia and Sedation Therapy for Children in Pediatric Intensive Care Unit of China",and combined with the existing research results,an expert group consisting of 5 experts and scholars in the field of pediatric intensive care was formed to conduct semi-structured interviews and formulate the draft of analgesia and sedation scheme led by PICU nurse for children with mechanical ventilation.Two rounds of Delphi expert consultation were conducted among 20 experts.The final management plan was determined based on the analysis of Kendall's coefficient of concordance(Kendall's W)and expert authority coefficient(Cr).Results:In the first round,the expert judgment basis(Ca),familiarity(Cs)and Cr were 0.895,0.888 and 0.892;In the second round,the Ca,Cs and Cr were 0.934,0.896 and 0.915.The Kendall's W of the two rounds of expert consultation was 0.337 and 0.412,respectively.The final version of the scheme covered 5 first-level indicators and 14 second-level indicators,with an item importance score of>4 points and a coefficient of variation of<0.20.Conclusion:The analgesia and sedation scheme led by PICU nurses for children with mechanical ventilation constructed in this study is scientific,and can better exert the subjective initiative of nurses and improve the quality of management.

关 键 词：儿童重症监护病房 机械通气 镇痛镇静 

分 类 号：R473.72[医药卫生—护理学]