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

Knowledge and performance of sepsis surveillance and early goal directed therapy among clinical nursing and medical staff

蔡淑妙(Shu-Miao Tsai) ； 邱艶芬(Yann-Fan Chao) ； 陳長志(Chang-Chih Chen)

《醫務管理期刊》 19卷4期 (2018/12) Pp. 299-315

https://doi.org/10.6174/JHM.201812_19(4).299

摘要

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。

關鍵字

早期目標導向治療 ； 死亡率 ； 敗血症監控 ； 敗血症處置

並列摘要

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.

並列關鍵字

early goal directed therapy ； mortality ； sepsis surveillance ； sepsis management

參考文獻

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