成人加護病房氣管內插管病人使用鎮靜劑是否可降低氣管內管自拔率教程文件.pptVIP

Evidence-Based Nursing;報告大綱;前言; 前 言1;背景描述1;背景描述2;93-95年7月呼吸器使用率;93-95年7月氣管內管滑脫率;實證護理動機與目的;EBN的動機與目的;實證護理五大步驟;EBN五大步驟;EBN-Thinking Matrix;Step 1: 臨床問題PICO;Definition of Terms;Step 1: 臨床問題PICO;Step 2: 尋找文獻證據 ;Step 2: 尋找文獻證據 ;;;輸入key words Sedation Unplanned Extubation;MeSH Database;;Step 2: 尋找文獻證據;Step 3: 嚴格評讀文獻;實證醫學之級別(美國健康照護政策及研究部)--US Agency for Health Care Policy and Research Classification (AHCPR, 1992);文獻評讀摘要(1-1) 【III】;文獻評讀摘要(1-2);文獻評讀摘要(1-3);;;文獻評讀摘要(1-4);文獻評讀摘要(1-5);文獻評讀摘要(1-5);討論 本篇指出SSE的關聯性：病人有high level of consciousness and lacked adequate sedation 建議 選擇適當的樣本數及同質性的個案 探討the relationship of continuous delivery of sedation and analgesia in preventing SSE in alert, intubated patients. ;文獻評讀摘要(2-1) 【III】;文獻評讀摘要(2-2);文獻評讀摘要(2-3);文獻評讀摘要(2-4);文獻評讀摘要(2-4);Weaning is extubate patients right after the half-life of the sedative drugs to avoid agitation when the sedation was completely weaned off. In fact, if the patient is agitated, the chance of SE increases. if his weaning parameters are not normal , more sedation and a later attempt are usually planned, leaving the patient intubated and therefore at risk of SE. ;結論 建議適當的使用約束與鎮靜劑 作者認為能降低SE 10 to 4% 增加awareness of potential SE The appropriate use of restrains 盡則的努力採用正確預防評量法 利用人員教育做好預防及密切觀察;文獻評讀摘要(3-1) 【III】;文獻評讀摘要(3-2);文獻評讀摘要(3-3);Modified Ramsay Scale;文獻評讀摘要(3-4);文獻評讀摘要(3-5);結論與討論;結論與討論;臨床應用與成效評值;臨床應用及成效評值;Sedation-Level Ib;未來護理方向-臨床應用;回饋與分享時間;感謝聆聽