目的了解ICU护士俯卧位通气(prone position ventilation，PPV)临床实施现况及障碍因素。方法采用便利抽样法，选取2023年3-4月山东省济南、青岛、济宁等5个地级市三甲医院急诊ICU、内科ICU、外科ICU、综合ICU等科室的ICU护士 230名，采用自行设计的一般资料调查问卷和ICU护士 PPV临床实施现状及障碍因素调查问卷进行调查。结果约＞90％的护士落实执行了 PPV流程规范的基本要求、评估要点、实施与护理要点，但ICU护士对患者实施俯卧位前进行镇痛镇静评估的执行率(85。4％)低于俯卧位期间镇痛镇静评估的执行率(91。3％)。PPV相关并发症中，压力性损伤(84。9％)、颜面部水肿(79。9％)、胃内容物反流与误吸(70。3％)发生率排名前3。ICU护士PPV临床实施障碍因素各维度得分由高到低依次是"证据相关因素""目标人群-患者或家属相关因素""资源相关因素""目标人群-医护人员相关因素""目标人群-团队相关因素""组织相关因素"。得分最高的条目是"证据相关因素"维度中的"相关证据适用范围有限，不是所有的患者都适合开展"。结论ICU护士 PPV临床实践态度较为积极，实施过程有待继续优化，应重点关注其实施过程的薄弱环节，并制定针对性措施，进一步完善PPV护理流程。
Investigation on clinical practice status and obstacle factors of prone position ventilation in ICU nurses
Objective To investigate the clinical implementation status and obstacle factors of prone position ven-tilation(PPV)in ICU nurses.Methods A total of 219 ICU nurses from emergency ICU,internal medicine ICU,sur-gery ICU,comprehensive ICU in 5 Class Ⅲ Grade A hospitals of Ji'nan,Qingdao,Jining,etc.in Shandong province between March and April,2023 were selected by convenience sampling method,and was investigated by a self-de-signed general information questionnaire and investigation questionnaire of ICU nurses PPV clinical implementation present situation and the obstacle factors.Results More than 90％of the nurses implemented the basic requirements,evaluation points,implementation and nursing points of PPV process specification,but the implementation rate(85.4％)of ICU nurses performing analgesic and sedation assessment before prone position was lower than that dur-ing prone position(91.3％).Among the complications related to PPV,the incidence of pressure injury(84.9％),facial edema(79.9％),and gastric contents reflux and aspiration(70.3％)ranked the top 3.The scores of each di-mension of clinical implementation obstacles of prone ventilation in ICU from high to low were"evidence related fac-tors","target population-patient or family related factors","resource related factors","target population-medical staff factors","target population-team factors",and"organization related factors".The item with the highest score was"relevant evidence was limited in scope and not all patients were suitable"in the dimension of"evidence related factors".Conclusions The clinical practice attitude of prone ventilation in ICU nurses is more positive,and the imple-mentation process needs to be further optimized.The weak links in the implementation process should be paid atten-tion to,and targeted measures should be developed to further improve the PPV nursing process.
intensive care unitnurseprone position ventilationobstacle factors
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