广州市某三甲医院儿童重症监护室护士镇静镇痛评估知识、态度及行为水平的调查研究
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摘要
目的:了解广州市某三甲儿童专科医院儿童重症监护室(PICU)护士镇静镇痛评估知识、态度及行为水平,探究其影响因素。方法:采用一般资料调查问卷、ICU护士镇静评估知识问卷及ICU护士镇静评估行为问卷、中文版儿科护士疼痛知识与态度调查量表对我院55名PICU护士进行一般资料、镇静镇痛评估知识、态度及行为水平的调查。结果:PICU护士镇静评估知识得分为(21.53±3.96)分,标准得分为(38.45±7.07)分,镇静评估知识处于低水平;PICU护士镇静评估行为得分为偏态分布,中位数为49分,四分位间距(44～52)分,标准得分为72.06分,镇静评估行为水平中等;PICU护士疼痛知识与态度得分为(16.69±4.10)分,标准得分为(40.70±10.00)分,水平较差。PICU护士镇静知识、疼痛知识与态度的影响因素为是否有ICU专科认证。结论:PICU护士镇静镇痛评估知识、态度及行为水平均不理想,建立多学科联合、符合护士培训需求、理论与实践相结合的镇静镇痛管理系统化培训课程刻不容缓。
Objective: To investigate the knowledge, attitude and behavior level of sedation and analgesia assessment among nurses in pediatric intensive care unit(PICU) of a Three-A hospital in Guangzhou, and to explore the influencing factors. Methods: The general information questionnaire, ICU nurse sedation assessment knowledge questionnaire, ICU nurse sedation assessment behavior questionnaire, and the Chinese version of Pediatric Nurses′ Knowledge and Attitudes Survey Regarding Pain were used to survey sedation and analgesia assessment knowledge, attitude and behavioral levels of 55 PICU nurses. Results: The PICU nurses′ sedation assessment knowledge score was(21.53±3.96), the standard score was(38.45±7.07), and the sedation assessment knowledge was at a low level. PICU nurse′s sedation assessment behavior score was skewed distribution, with the median of 49, interquartile range 44-52, the standard score was 72.06, and the sedation assessment behavior level was medium level. PICU nurses′ pain knowledge and attitude score was(16.69±4.10), and the standard score was(40.70±10.00), and the pain knowledge and attitude level were at a low level. The influencing factor of PICU nurses′ sedation knowledge, pain knowledge and attitude was whether has ICU specialty nurse certification. Conclusion: PICU nurses′ sedation and analgesia assessment knowledge, attitude and behavior are not ideal. It is imperative to establish the systematic training course for sedation and analgesia management that is multi-disciplinary, meets nurse training need, and combines theory and practice.
Objective: To investigate the knowledge, attitude and behavior level of sedation and analgesia assessment among nurses in pediatric intensive care unit(PICU) of a Three-A hospital in Guangzhou, and to explore the influencing factors. Methods: The general information questionnaire, ICU nurse sedation assessment knowledge questionnaire, ICU nurse sedation assessment behavior questionnaire, and the Chinese version of Pediatric Nurses′ Knowledge and Attitudes Survey Regarding Pain were used to survey sedation and analgesia assessment knowledge, attitude and behavioral levels of 55 PICU nurses. Results: The PICU nurses′ sedation assessment knowledge score was(21.53±3.96), the standard score was(38.45±7.07), and the sedation assessment knowledge was at a low level. PICU nurse′s sedation assessment behavior score was skewed distribution, with the median of 49, interquartile range 44-52, the standard score was 72.06, and the sedation assessment behavior level was medium level. PICU nurses′ pain knowledge and attitude score was(16.69±4.10), and the standard score was(40.70±10.00), and the pain knowledge and attitude level were at a low level. The influencing factor of PICU nurses′ sedation knowledge, pain knowledge and attitude was whether has ICU specialty nurse certification. Conclusion: PICU nurses′ sedation and analgesia assessment knowledge, attitude and behavior are not ideal. It is imperative to establish the systematic training course for sedation and analgesia management that is multi-disciplinary, meets nurse training need, and combines theory and practice.
引文
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[2] Neunhoeffer F,Kumpf M,Renk H,et al.Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients[J].Paediatr Anaesth,2015,25(8):786-794.
[3] 银杏,成守珍,林春喜,等.ICU护士镇静评估知识与行为的相关性研究[J].护理学杂志,2016,31(15):5-8.
[4] Manworren RC.Development and testing of the pediatric nurses′ knowledge and attitudes survey regarding pain[J].Pediatr Nurs,2001,27(2):151-158.
[5] 孟玮亿,徐丽华,张跃晖,等.对儿科护士疼痛知识的调查[J].解放军护理杂志,2006,23(10):26-28.
[6] 王婷,花芸,涂红星,等.华中地区儿科护士疼痛管理知识及态度的现状调查[J].中华护理杂志,2016,51(6):681-685.
[7] 陶然,陈利群,吴俊梅,等.上海市三级甲等医院重症监护室护士机械通气镇静知识的调查[J].护理研究,2012,26(33):3085-3087.
[8] 杨玉凤,杨丽翠,高艳红,等.北京市ICU护士镇静相关知识和态度调查[J].护理学杂志,2016,31(14):55-58.
[9] 姚文艳,王婷,花芸.儿科重症监护病区与普通病区护士对儿童疼痛认知的调查比较[J].重庆医学,2016,40(30):4267-4270.
[10] 王英杰,孙静,李菀,等.113名儿科护士的患儿疼痛管理认知现状[J].中华护理杂志,2013,48(2):167-169.
[11] 周丹,孙运波,姜文彬,等.ICU医护人员对疼痛、躁动和谵妄管理循证知识的认知调查[J].护理管理杂志,2014,14(11):780-782.
[12] 潘曦晖,易尚辉,易银沙,等.118名儿科重症监护室护士小儿疼痛知信行分析[J].护理学报,2014,(5):6-8.
[13] 吴敏,龙良平,花芸.儿童疼痛管理短期培训课程设计及实施效果[J].护理学杂志,2017,32(16):7-10.
[14] 石崛,林王莹,梁小英.医护合作培训在重症医学科镇痛和镇静安全管理中的应用[J].中华现代护理杂志,2016,22(30):4411-4414.
[15] Jest AD,Tonge A.Using a learning needs assessment to identify knowledge deficits regarding procedural sedation for pediatric patients[J].AORN J,2011,94(6):567-577.
[16] Crego N,Baernholdt M,Merwin E.Differences in pediatric non-interventional radiology procedural sedation practices and adverse events by registered nurses and physicians[J].J Pediatr Nurs,2017,35:129-133.
[17] Kamat PP,McCracken CE,Gillespie SE,et al.Pediatric critical care physician-administered procedural sedation using propofol:a report from the Pediatric Sedation Research Consortium Database[J].Pediatr Crit Care Med,2015,16(1):11-20.
[18] 许峰.PICU患儿镇痛镇静治疗的目的和意义[J].中国小儿急救医学,2014,21(2):68-69,73.
[19] Connors JM,Cravero JP,Kost S,et al.Great expectations-defining quality in pediatric sedation:outcomes of a multidisciplinary consensus conference[J].J Healthc Qual,2015,37(2):139-154.
[20] Doctor K,Roback MG,Teach SJ.An update on pediatric hospital-based sedation[J].Curr Opin Pediatr,2013,25(3):310-316.
[2] Neunhoeffer F,Kumpf M,Renk H,et al.Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients[J].Paediatr Anaesth,2015,25(8):786-794.
[3] 银杏,成守珍,林春喜,等.ICU护士镇静评估知识与行为的相关性研究[J].护理学杂志,2016,31(15):5-8.
[4] Manworren RC.Development and testing of the pediatric nurses′ knowledge and attitudes survey regarding pain[J].Pediatr Nurs,2001,27(2):151-158.
[5] 孟玮亿,徐丽华,张跃晖,等.对儿科护士疼痛知识的调查[J].解放军护理杂志,2006,23(10):26-28.
[6] 王婷,花芸,涂红星,等.华中地区儿科护士疼痛管理知识及态度的现状调查[J].中华护理杂志,2016,51(6):681-685.
[7] 陶然,陈利群,吴俊梅,等.上海市三级甲等医院重症监护室护士机械通气镇静知识的调查[J].护理研究,2012,26(33):3085-3087.
[8] 杨玉凤,杨丽翠,高艳红,等.北京市ICU护士镇静相关知识和态度调查[J].护理学杂志,2016,31(14):55-58.
[9] 姚文艳,王婷,花芸.儿科重症监护病区与普通病区护士对儿童疼痛认知的调查比较[J].重庆医学,2016,40(30):4267-4270.
[10] 王英杰,孙静,李菀,等.113名儿科护士的患儿疼痛管理认知现状[J].中华护理杂志,2013,48(2):167-169.
[11] 周丹,孙运波,姜文彬,等.ICU医护人员对疼痛、躁动和谵妄管理循证知识的认知调查[J].护理管理杂志,2014,14(11):780-782.
[12] 潘曦晖,易尚辉,易银沙,等.118名儿科重症监护室护士小儿疼痛知信行分析[J].护理学报,2014,(5):6-8.
[13] 吴敏,龙良平,花芸.儿童疼痛管理短期培训课程设计及实施效果[J].护理学杂志,2017,32(16):7-10.
[14] 石崛,林王莹,梁小英.医护合作培训在重症医学科镇痛和镇静安全管理中的应用[J].中华现代护理杂志,2016,22(30):4411-4414.
[15] Jest AD,Tonge A.Using a learning needs assessment to identify knowledge deficits regarding procedural sedation for pediatric patients[J].AORN J,2011,94(6):567-577.
[16] Crego N,Baernholdt M,Merwin E.Differences in pediatric non-interventional radiology procedural sedation practices and adverse events by registered nurses and physicians[J].J Pediatr Nurs,2017,35:129-133.
[17] Kamat PP,McCracken CE,Gillespie SE,et al.Pediatric critical care physician-administered procedural sedation using propofol:a report from the Pediatric Sedation Research Consortium Database[J].Pediatr Crit Care Med,2015,16(1):11-20.
[18] 许峰.PICU患儿镇痛镇静治疗的目的和意义[J].中国小儿急救医学,2014,21(2):68-69,73.
[19] Connors JM,Cravero JP,Kost S,et al.Great expectations-defining quality in pediatric sedation:outcomes of a multidisciplinary consensus conference[J].J Healthc Qual,2015,37(2):139-154.
[20] Doctor K,Roback MG,Teach SJ.An update on pediatric hospital-based sedation[J].Curr Opin Pediatr,2013,25(3):310-316.