Effect of goal-oriented sedation nursing in mechanical ventilation patients in emergency department and its influence on the incidence of delirium
目标导向镇静护理在急诊科机械通气患者中的实施效果及对谵妄发生率的影响

摘要

目的 探讨目标导向镇静护理在急诊科机械通气患者中的实施效果及对谵妄发生率的影响。方法 选取2023年1月至2024年1月于本院急诊科接受机械通气治疗的86例患者作为研究对象，采用随机数字表法将其分为对照组和观察组，每组各43例。对照组实施常规镇静护理，观察组实施目标导向镇静护理。比较两组患者的镇静达标时间、谵妄发生率两个核心观察指标，同时记录两组患者的机械通气时间、住院时间及不良事件发生情况。结果 观察组患者的镇静达标时间为（2.35±0.62）h，显著短于对照组的（3.82±0.75）h（P＜0.05）；观察组患者的谵妄发生率为9.30%（4/43），显著低于对照组的27.91%（12/43）（P＜0.05）。此外，观察组患者的机械通气时间、住院时间均短于对照组，不良事件发生率低于对照组（P＜0.05）。结论 对急诊科机械通气患者实施目标导向镇静护理，可有效缩短镇静达标时间，降低谵妄发生率，同时缩短患者的机械通气时间和住院时间，减少不良事件的发生，具有较高的临床应用价值。

Abstract

Objective To investigate the implementation effects of goal-directed sedation nursing in emergency department patients undergoing mechanical ventilation and its impact on delirium incidence.
Methods A total of 86 patients receiving mechanical ventilation treatment in our hospital’s emergency department from January 2023 to January 2024 were selected as research subjects. They were randomly divided into a control group (43 cases) and an observation group (43 cases) using a random number table method. The control group received routine sedation nursing, while the observation group received goal-directed sedation nursing. Two core observation indicators—sedation attainment time and delirium incidence—were compared between the two groups. Additionally, mechanical ventilation duration, hospitalization duration, and adverse event occurrences were recorded.
Results The sedation attainment time in the observation group was (2.35±0.62) hours, significantly shorter than the control group’s (3.82±0.75) hours (P<0.05). The delirium incidence rate in the observation group was 9.30% (4/43), significantly lower than the control group’s 27.91% (12/43) (P<0.05). Moreover, the observation group showed shorter mechanical ventilation duration, shorter hospitalization duration, and lower adverse event rates compared to the control group (P<0.05).
Conclusion   Implementing goal-directed sedation nursing for emergency department patients undergoing mechanical ventilation can effectively shorten sedation attainment time, reduce delirium incidence, and simultaneously decrease mechanical ventilation duration and hospitalization time while reducing adverse events. This approach demonstrates significant clinical application value.