ICU看護の早期離床プロトコール

ICUでの看護による早期離床プロトコールの研究を紹介します。

Zomorodi M, Topley D, McAnaw M.　Developing a mobility protocol for early mobilization of patients in a surgical/trauma ICU.　Crit Care Res Pract. 2012;2012:964547. doi: 10.1155/2012/964547.

下記のHPで全文見ることができます。

http://www.hindawi.com/journals/ccrp/2012/964547/

ICUでの早期離床はリスクがないわけではありませんが、人工呼吸器管理下でも安全に実現可能というエビデンスがあります。このような患者は廃用性筋萎縮のリスクが高いので、重症患者看護師による早期離床プロトコールの実践は重要です。

当パイロット研究では、早期離床プロトコールの安全性と実現可能性を検証しています。3人の患者さんで行っただけですので本当にパイロット研究ですが、早期離床プロトコールを各施設で導入するためには必要な過程だと思います。

Abstract

As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs), so it is now important to focus on improving the patient outcomes and recovery. To do this, ICU patients need to be assessed and started on an early mobility program, if stable. While the early mobilization of the ICU patients is not without risk, the current literature has demonstrated that patients can be safely and feasibly mobilized, even while requiring mechanical ventilation. These patients are at a high risk for muscle deconditioning due to limited mobility from numerous monitoring equipment and multiple medical conditions. Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test. The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay. This paper describes a pilot study to evaluate an early mobilization protocol to test the safety and feasibility for mechanically ventilated patients in a surgical trauma ICU in conjunction with the current unit standards.