By ICU Clinicians: Patent-pending device to reduce ICU nursing staff workload in managing patients coming off ventilation focussed on reducing lifting and transmission risk

** 上下文 **：由于COVID-19，每个ICU护士现在至少要照顾3名患者，而不是COVID-19前建议的每2名患者最多1名护士。（即可用护士减少）沿着病例增多导致的工作量增加，需要使用新的工作方法/技术来减少护理工作量。**愿景：开发一种简单的机械装置，以确保患者保持在最佳位置，以优化其呼吸（通气）机制，从而优化氧合，改善患者的治疗效果，同时减少护士移动患者的需要。这一点很重要，因为在ICU中，许多患者每天至少需要重新定位一次，导致临床工作人员在他们护理的患者中通常每天重新定位患者12次。减少对患者重新定位的需求可以减少反复提起的身体压力（护理人员受伤的主要原因），并减少与患者的直接接触（对降低传播风险很重要）。目的：** 完成在国家卫生服务（“NHS”）重症监护室（ICU）中进行试验的设备的开发，该设备将 ** 在“拔管”**（即人工通气）时将患者保持在最佳呼吸位置进行氧合和工作量，并减少护理工作量和传播风险。焦点 **：当患者拔管时，由于多种因素（疾病、受伤和治疗中使用的药物），他们通常非常虚弱。为了改善呼吸的力学，他们坐在ICU病床上，中间弯曲，以方便倾斜直立的位置。然而，由于肌肉力量的丧失，患者通常无法保持这种姿势并滑下床。这会影响他们的呼吸，导致他们的血氧饱和度下降。在ICU或高依赖性单位（HDU），人们经常听到血氧饱和度计报警。通常，护理团队中的一个将评估患者，并且在许多情况下，恢复令人满意的氧合所需的全部是重新定位患者以恢复有效通气的最佳位置，这通常需要2名护士每人5分钟。重点：减少/消除重新定位患者的需要，以减少护士的工作量。**

**Context**: Due to COVID-19 each ICU nurse is now looking after at least 3 patients when they are taken off a ventilator, rather than the pre-COVID-19 recommended maximum of 1 nurse for every 2 patients.The attrition of nurses due to being exposed to COVID-19 (i.e. less nurses available) along with increased workload resulting from more cases, creates a need to use new working methods/technologies to reduce nursing workload.**Vision: To develop a simple mechanical device to ensure patients remain in the best position to optimize the mechanics of their breathing (ventilation) and hence oxygenation, improving patient outcomes while reducing the need for nurses to physically move patients.**This is important as in an ICU many of the patients will need reposition at least once per day, resulting in clinical staff repositioning patients typically 12 times per day across the patients they care for. Reducing the need to reposition patients reduces the physical stress from repeated lifting (a major cause of injury to nursing staff) and reduces direct patient contact (important in reducing transmission risk).**Objective:** To complete development of a device for trial in a National Health Service ('NHS') Intensive Care Unit (ICU) that will **maintain patients in the optimal breathing position for oxygenation and workload when they are 'extubated'** (i.e. come-off artificial ventilation) and reduce nursing workload and the risk of transmission.**Focus**: When patients are extubated they are frequently extremely weak due to a combination of factors (illness, injury and the drugs used in their treatment). To improve the mechanics of breathing, they are sat up in their ICU beds which bend in the middle to facilitate a reclined upright position. Often however, due to their loss of muscle strength, the patients are unable to maintain this position and slide down the bed. This can then compromise their breathing and cause their oxygen saturation to drop.In an ICU or High-Dependency Unit (HDU) one often hears the blood oxygen saturation meters alarming. Ordinarily one of the nursing team will assess the patient and, in many cases, all that is required to restore satisfactory oxygenation is to reposition the patient to restore the optimal position for efficient ventilation which typically takes 2 nurses 5 minutes each.**Focus: Reduce/eliminate the need to reposition patients in order to reduce nurse workload.**