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

**背景**：由于COVID-19，现在每个ICU护士在取下呼吸机时至少照顾3名患者，而不是COVID-19前建议的每2名患者最多1名护士。由于接触COVID-19导致护士减员（即可用护士减少），加上病例增多导致工作量增加，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，从而实现氧合，改善患者预后，同时减少护士身体移动患者的需要。**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，导致临床工作人员通常每天在他们照顾的患者中重新定位患者12次。减少重新安置病人的需要，可减少反复抬起病人造成的身体压力（护理人员受伤的一个主要原因），并减少与病人的直接接触（对减少传播风险很重要）。**目的：**完成在国家卫生服务（“NHS”）重症监护病房（ICU）试验的设备的开发，该设备将**在“拔管”时（即取消人工通气）将患者维持在最佳呼吸姿势以供氧和工作量**，并减少护理工作量和传播风险。**焦点**：拔管时，由于多种因素（疾病、损伤和治疗中使用的药物），患者往往非常虚弱。为了改善呼吸机制，他们在ICU床上坐直，中间弯曲以促进斜倚的直立位置。然而，由于肌肉力量的丧失，患者往往无法保持这个姿势并滑下床。这会损害他们的呼吸，导致他们的血氧饱和度下降。在ICU或高依赖病房（HDU），人们经常听到血氧饱和度仪发出警报。通常情况下，一个护理小组将评估患者，在许多情况下，恢复令人满意的氧合所需要的全部是重新调整患者的位置，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/消除重新安置病人的需要，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.**