INTENSIVE CARE NURSES' PERCEPTIONS OF ROUTINE DYSPNEA ASSESSMENT
INTENSIVE CARE NURSES' PERCEPTIONS OF ROUTINE DYSPNEA ASSESSMENT
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DOI：
10.4037/ajcc2020711
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发表时间：
2020-03-01
影响因子：
2.7
通讯作者：
Banzett, Robert B.
中科院分区：
文献类型：
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作者：
Baker, Kathy M.;Vragovic, Natalia Sullivan;Banzett, Robert B.
背景呼吸困难（呼吸不适）是危重患者的常见症状，目前尚未进行常规评估和记录。重症监护室护士最近开始对所有能够报告的患者进行常规呼吸困难评估和记录，使用0 - 10的数字量表。目的评估护士对常规呼吸困难测量的效用、患者对评估问题的理解以及对护理实践的影响，并收集护士的改进建议。方法通过对重症监护室护士的小型焦点小组访谈和随机分配给所有重症监护室护士的匿名在线调查获得数据。在实施测量工具之前，护士通常通过使用观察到的体征来评估患者的呼吸不适。大多数护士同意常规评估可以用来预测病人的结果，提高以病人为中心的护理。护士发现评估工具易于使用，并报告说，它不会干扰工作流程。护士认为，患者能够提供有意义的评级的呼吸困难，类似于疼痛的评级，并经常使用患者的评级结合观察到的体征，以优化患者care.Conclusion我们的研究表明，护士了解常规呼吸困难评估的重要性，并增加了一个简单的患者报告规模可以提高护理服务，并不增加工作流程的负担。
Background Dyspnea (breathing discomfort) is commonly experienced by critically ill patients and at this time is not routinely assessed and documented. Intensive care unit nurses at the study institution recently instituted routine assessment and documentation of dyspnea in all patients able to report using a numeric scale ranging from 0 to 10.Objective To assess nurses' perceptions of the utility of routine dyspnea measurement, patients' comprehension of assessment questions, and the impact on nursing practice and to gather nurses' suggestions for improvement. Methods Data were obtained from interviews with intensive care unit nurses in small focus groups and an anonymous online survey randomly distributed to nurses representing all intensive care units.Results Intensive care unit nurses affirmed the importance of routine dyspnea assessment and documentation. Before implementing the measurement tool, nurses often assessed for breathing discomfort in patients by using observed signs. Most nurses agreed that routine assessment can be used to predict patients' outcomes and improve patient-centered care. Nurses found the assessment tool easy to use and reported that it did not interfere with workflow. Nurses felt that patients were able to provide meaningful ratings of dyspnea, similar to ratings of pain, and often used patients' ratings in conjunction with observed physical signs to optimize patient care.Conclusion Our study shows that nurses understand the importance of routine dyspnea assessment and that the addition of a simple patient report scale can improve care delivery and does not add to the burden of workflow.