Publication in refereed journal
香港中文大学研究人员 ( 现职)
| Professor Charles David GOMERSALL (麻醉及深切治疗学系) |
| Professor Gavin Matthew JOYNT (麻醉及深切治疗学系) |
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Scopushttp://aims.cuhk.edu.hk/converis/portal/Publication/6Scopus source URL
其它资讯
摘要Purpose: Positioning mechanically ventilated patients in an adequate semi-recumbent position is a low cost and apparently easy applied measure to prevent new VAP. We performed an unannounced audit to compare the actual backrest angle with the target backrest angle of 30-45 degrees, assess whether compliance was better in patients whose bed had a built-in bedside protractor, and document difficulties reported when failing to achieve the target backrest angle. Methods: From 1/3/2007 to 30/http://aims.cuhk.edu.hk/converis/portal/Publication/6/2007, unannounced ad hoc inspections were made on patients receiving mechanical ventilation in the intensive care unit. During inspections, the angle of elevation of bed was formally measured by a manual technique using a hand-held protractor. The nurse at bed-side was also asked to estimate the angle of elevation of bed without referring to the built-in protractor and interviewed with a structured questionnaire. Results: From 1/3/2007 to 30/http://aims.cuhk.edu.hk/converis/portal/Publication/6/2007, inspections were made on 295 occasions. The median angle of backrest elevation was 25 degrees (interquartile range [IQR]: 20 to 30 degrees). The median angle of elevation estimated by the nurse at the bed-side was 30 (IQR: 20 to 30 degrees), (p <0.001). Semi-recumbent positions meeting the 30 degree minimum target angle were observed on only 120 (41%) occasions. Reasons provided for failing to achieve the target angle included incorrect estimation of the backrest angle and interference of the semi-recumbent position with nursing procedures and nursing inconvenience. Conclusions: This audit showed that the minimum target semi-recumbent position of 30 degrees was achieved only 40% of the time in an academic intensive care unit. Nurses at bedside consistently overestimated the angle of elevation of bed, and the presence of a built-in bedside protractor was not associated with a greater compliance with the target backrest elevation angle. Strictly enforced protocols, education programs for nurses and doctors and regular audit may improve compliance with backrest elevation targets.
着者Li T.S.T., Joynt G.M., So H.Y., Gomersall C.D., Yap F.H.Y.
期刊名称CRITICAL CARE AND SHOCK
出版年份2008
月份5
日期1
卷号11
期次2
出版社Indonesian Society of Critical Care Medicine
出版地Indonesia
页次http://aims.cuhk.edu.hk/converis/portal/Publication/61 - http://aims.cuhk.edu.hk/converis/portal/Publication/6http://aims.cuhk.edu.hk/converis/portal/Publication/6
国际标準期刊号1410-77http://aims.cuhk.edu.hk/converis/portal/Publication/67
语言英式英语
关键词"Mechanical ventilation", "Ventilator-associated pneumonia", Aspiration, Education, Protocol
