Summary of the best evidence for tracheal intubation management in neurological critical ill patients and its application effects
10.3760/cma.j.cn115682-20230521-02005
- VernacularTitle:神经重症患者气管插管管理的最佳证据总结及其应用效果研究
- Author:
Yingying ZHANG
1
;
Lixinbei SHENG
;
Bo XU
Author Information
1. 南京大学医学院附属鼓楼医院神经外科，南京 210008
- Keywords:
Evidence-based nursing;
Neurological critical ill;
Tracheal intubation;
Artificial airway;
Application of evidence
- From:
Chinese Journal of Modern Nursing
2024;30(1):45-54
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the best evidence for tracheal intubation management in neurological critical ill patients and explore its application effect.Methods:The Clinical Evidence Practice Application System of Joanna Briggs Institute in Australia was adopted to retrieve and summarize the best evidence, develop appropriate review indicators based on clinical scenarios and professional judgement, identify obstacles to the application of evidence, and construct the best action strategy. Using the convenient sampling method, a total of 68 nurses from the Neurosurgical Care Unit of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, 98 tracheal intubation patients during baseline review from January to April 2022, and 99 tracheal intubation patients after evidence application from September to December 2022 were selected as the research objects. Before and after evidence-based practice, the implementation rate of review indicators, nurses' knowledge of tracheal intubation management in neurocritical critical ill patients, and the incidence of patients' airway complications (oral mucosal ulcer, airway mucosal hemorrhage, tracheoesophageal fistula, pulmonary infection) were compared.Results:A total of 28 best evidences were summarized and corresponding review indicators were developed. Except for six review indicators (indicators 11, 13, 19, 20, 27, 28), which increased from 97.96%-100.00% before evidence-based practice to 100.00%, the differences were not statistically significant ( P>0.05), and the implementation rates of the remaining 22 review indicators were improved after evidence-based practice. Among them, the implementation rates of eight indicators (indicators 5, 6, 9, 14, 18, 21, 25, 26) increased from 0 to 89.90%-100.00%, and the differences were statistically significant ( P<0.05). After evidence-based practice, the scores of nurses' knowledge of tracheal intubation management in neurological critical ill patients increased from (62.41±6.07) to (93.82±2.74), and the difference was statistically significant ( P<0.05). Except for tracheoesophageal fistula, the incidence of other airway complications were decreased in all patients, and the differences were statistically significant ( P<0.05) . Conclusions:An evidence-based programme for the management of endotracheal intubation in neurocritical care patients can improve nurses' knowledge of tracheal intubation management for neurological critical ill patients, reduce the incidence of airway complications and improve the clinical outcome of them.
