摘要
目的探索强化培训和督导干预对预防重症监护病房(ICU)呼吸机相关性肺炎(VAP)的临床应用效果。方法选择2017年3月至2018年3月入住驻马店市第一人民医院ICU经口气管插管的机械通气患者241例作为研究对象;将2017年3-8月进行呼吸机的常规治疗和护理的患者作为对照组(119例),将2017年9月至2018年3月被强化培训和督导后的工作人员进行治疗和护理的患者作为观察组(122例);开展VAP预防与控制措施的依从性监测(相关知识知晓率、手卫生、口腔护理、半卧位等依从性),同时监测呼吸机使用时间及平均住院时间和VAP发生率。结果观察组患者半卧位依从性达97.54%(119/122)、工作人员相关知识知晓率达95.90%(117/122)、手卫生依从性达92.62%(113/122)、口腔护理每8小时1次完成率达100.00%(122/122),均优于对照组;观察组患者呼吸机使用时间、平均住院时间明显较对照组缩短;观察组患者VAP发生率[13.11%(16/122)]明显低于对照组[24.37%(29/119)],差异均有统计学意义(P<0.05)。结论强化培训和督导干预对预防VAP具有积极意义,可提高手卫生、口腔护理每8小时1次、半卧位等依从性,缩短了机械通气及ICU住院时间,从而显著降低了VAP发生率。
Objective To explore the clinical application effect of intensive training and supervision intervention on the prevention of ICU ventilator-associated pneumonia(VAP). Methods A total of 241 patients with mechanical ventilation through mouth trachea intubation admitted to Zhumadian Municipal First People′s Hospital ICU from March 2017 to March 2018 were selected as the study subjects,119 patients treated by respirator and nursing routine from March to August 2017 served as the control group,122 patients with the treatment and nursing after intensified training and supervisory on the staffs from September 2017 to March 2018 served as the observation group.Then the compliance monitoring of VAP prevention and control measures(compliances such as related knowledge awareness,hand hygiene,oral care,semi-lying position) was carried out,meanwhile the use time of respiratory machines,average hospitalization days and incidence rate of VAP were monitored. Results After intensive training and supervision intervention,the semi-lying position compliance reached 97.54%(119/122),the related knowledge awareness rate reached 95.90%(117/122),the compliance of hand hygiene reached 92.62%(113/122),the completion rate of once oral care per 8 h reached 100.00%(122/122),which all were superior to the control group;the ventilator use time and average hospitalization time in the observation group were significantly shortened than those in control group;the incidence rate of VAP was 13.11%(16/122),which was significantly lower than 24.37%(29/119) in the control group,the differences were statistically significant ( P < 0.05 ). Conclusion Enhanced training and supervised intervention have the positive significance for the prevention of VAP and can improve the compliances such as hand hygiene,once oral care per 8 h and semi-lying position,shorten the mechanical ventilation and ICU hospitalization time,thus significantly reduce the incidence rate of VAP.
作者
吴杰
李福琴
刘海娜
WU Jie;LI Fuqin;LIU Haina(Department of Infection Management,Zhumadian Municipal First People′s Hospital,Zhumadian,Henan 463000,China;Department of Infection Management,First Affiliated Hospital ofZhengzhou University,Zhengzhou,Henan 450003,China;Department of Neonatal ICU,Zhumadian MunicipalFirst People′s Hospital,Zhumadian,Henan 463000,China)
出处
《现代医药卫生》
2019年第10期1468-1470,共3页
Journal of Modern Medicine & Health
基金
河南省科技攻关计划基金资助项目(162102310155)
关键词
呼吸
人工
肺炎
呼吸机相关性
重症监护病房
强化培训和督导干预
Respiration,artificial
Pneumonia,ventilator-associated
Intensive care units
Intensified training and supervisory intervention
