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題名:臨床醫護人員對敗血症早期症狀與早期目標導向治療之認知度與執行度之探討
書刊名:醫務管理期刊
作者:蔡淑妙邱艶芬 引用關係陳長志
作者(外文):Tsai, Shu-miaoChao, Yann-fanChen, Chang-chih
出版日期:2018
卷期:19:4
頁次:頁299-315
主題關鍵詞:早期目標導向治療死亡率敗血症監控敗血症處置Early goal directed therapyMortalitySepsis surveillanceSepsis management
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:0
  • 點閱點閱:6
目的:本研究探討某醫學中心醫護人員對敗血症危險群、早期症狀及早期目標導向治療(early goal-directed therapy, EGDT)之認知與執行度。方法:採問卷調查法,自2018年4月至5月進行收案,合計發出問卷425份,有效問卷400份,回收率為94.1%,所得數據以SPSS進行Chi-square, t-test, Pearson correlation等資料分析。結果:研究結果認知及執行之間呈弱負相關,顯示醫護同仁雖對敗血症的認知度越高,反而執行度會較低,但監測生化指標之認知得分與多項執行處置呈弱正相關,顯示監測生化指標之認知高者,臨床上還是會主動去留意病人有無敗血症早期徵兆。結論:臨床醫護同仁對敗血症之認知及警覺性不足。提升醫護人員對敗血症危險群、早期症狀及早期目標導向治療之認知與執行度,除可再加強教育外,建議能建置敗血症早期監測系統,當偵測到異常警訊時,提醒醫護人員早期處置,此為敗血症防範之最佳策略。
Objectives: The purpose of this study is to examine the knowledge and performance of sepsis surveillance and early goal directed therapy among clinical nursing and medical staff, given their impact on the effective of the sepsis management. Methods: 85 MD, 45 CNS, and 270 RNs who participated in care of trauma patients, voluntarily filled-out a "Knowledge and performance of EGDT questionnaire" to deliver data for data analysis. Results: The scores of awareness of sepsis risk patients and alertness on SIRS, as well as the performance of EGDT, were unsatisfactory in MD, CNS and RN groups. Also poor association between knowledge and performance of EGDT was found. Conclusions: In addition to educational training, an alert system with SOP guidelines may be more effective to early detection and effective management of sepsis for trauma patients.
期刊論文
1.Rivers, E.、Nguyen, B.、Havstad, S.、Ressler, J.、Muzzin, A.、Knoblich, B.、Tomlanovich, M.(2001)。Early goal-directed therapy in the treatment of severe sepsis and septic shock。The New England Journal of Medicine,345(19),1368-1377。  new window
2.Cho, W. H.(2015)。Update of Sepsis: Recent evidences about early goal directed therapy。Tuberculosis and Respiratory Diseases,78(3),156-160。  new window
3.Gould, D. J.、Moralejo, D.、Drey, N.、Chudleigh, J. H.、Taljaard, M.(2017)。Interventions to improve hand hygiene compliance in patient care。Cochrane Database of Systematic Reviews,9,CD005186。  new window
4.Gu, W. J.、Wang, F.、Bakker, J.、Tang, L.、Liu, J. C.(2014)。The effect of goal-directed therapy on mortality in patients with sepsis-- earlier is better: a meta-analysis of randomized controlled trials。Critical Care,18(5),570。  new window
5.Gupta, R. G.、Hartigan, S. M.、Kashiouris, M. G.、Sessler, C. N.、Bearman, G. M.(2015)。Early goal-directed resuscitation of patients with septic shock: current evidence and future directions。Critical Care,19,286。  new window
6.Laskar, A. M. R. D.、Bhat, P.、Pottakkat, B.、Narayan, S.、Sastry, A. S.、Sneha, R.(2018)。A multimodal intervention to improve hand hygiene compliance in a tertiary care center。American Journal of Infection Control,46(7),775-780。  new window
7.Levy, M. M.(2014)。Early goal-directed therapy: what do we do now?。Critical Care,18(6),705。  new window
8.Li, Z. Q.、Xi, X. M.、Luo, X.、Li, J.、Jiang, L.(2013)。Implementing surviving sepsis campaign bundles in China: a prospective cohort study。Chinese Medical Journal,126(10),1819-1825。  new window
9.Luangasanatip, N.、Hongsuwan, M.、Limmathurotsakul, D.、Lubell, Y.、Lee, A. S.、Harbarth, S.、Cooper, B. S.(2015)。Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis。British Medical Journal,351,h3728。  new window
10.Nguyen, H. B.、Jaehne, A. K.、Jayaprakash, N.、Semler, M. W.、Hegab, S.、Yataco, A. C.、Rivers, E. P.(2016)。Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE。Critical Care,20(1),160。  new window
11.Phua, J.、Koh, Y.、Du, B.、Tang, Y. Q.、Divatia, J. V.、Tan, C. C.、Chan, Y. H.(2011)。Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study。British Medical Journal,342,d3245。  new window
12.Rhodes, A. I.、Evans, L. E.、Alhazzani, W.、Levy, M. M.、Antonelli, M.、Ferrer, R.、Dellinger, R. P.(2017)。Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016。Intensive Care Medicine,43(3),304-377。  new window
13.Worapratya, P.、Wanjaroenchaisuk, A.、Joraluck, J.、Wuthisuthimethawee, P.(2016)。Success of applying early goal-directed therapy for septic shock patients in the emergency department。Open Access Emergency Medicine,8,1-6。  new window
14.Yu, H.、Chi, D.、Wang, S.、Liu, B.(2016)。Effect of early goal-directed therapy on mortality in patients with severe sepsis or septic shock: a meta-analysis of randomised controlled trials。British Medical Journal Open,6(3),e008330。  new window
其他
1.台中榮民總醫院(2010)。嚴重敗血症早期目標導向治療警示照護跟隨系統,http://www3.vghtc.gov.tw:8080/nurseweb/goodIdea/NURS/99PDF.pdf。  延伸查詢new window
2.國泰醫療財團法人國泰綜合醫院(2015)。運用組合式照護模式提升急診敗血症病人處置效益,http://www.snq.org.tw/chinese/03_service/02_detail.php?pdid=2870。  延伸查詢new window
 
 
 
 
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