ICU呼吸机相关性肺炎预防控制质量核查单的设计及应用

发布时间：2019-01-01 16:26

【摘要】：目的通过设计《ICU呼吸机相关性肺炎预防控制质量核查单》(简称核查单),指导护理人员在临床工作中进行质量核查,以降低呼吸机相关性肺炎的发生率,促进呼吸机相关性肺炎预防的质量改进。方法采用类实验性研究方法,2015年5—7月,将核查单应用于ICU的机械通气患者,对呼吸机相关性肺炎预防控制措施进行每日核查;将使用核查单的2015年5—7月患者作为干预组,未使用核查单的2015年1—3月患者作为对照组,比较两组呼吸机相关性肺炎预防控制措施的总执行率、单项执行率和呼吸机相关性肺炎的发生率。结果使用核查单干预后,呼吸机相关性肺炎预防控制措施的总执行率提高(31.8%vs 54.5%),呼吸机相关性肺炎发生率明显下降(34.2‰ vs 14.6‰)。预防控制措施中"手卫生"、"抬高床头30°~45°"、"口腔护理"、"镇静休假"、"深静脉血栓预防"、"人工气道管理"的单项执行率均提高,使用前后上述各指标的差异有统计学意义(P0.05),"消化道溃疡预防"的单项执行率未提高。结论应用《ICU呼吸机相关性肺炎预防控制质量核查单》有助于提高多项呼吸机相关性肺炎预防控制措施的执行率,降低呼吸机相关性肺炎的发生率。
[Abstract]:Objective to design a quality check list for prevention and control of ICU ventilator-associated pneumonia (abbreviated as "check list") to guide nursing staff to carry out quality verification in clinical work in order to reduce the incidence of ventilator-associated pneumonia. To improve the quality of ventilator-associated pneumonia prevention. Methods in May to July 2015, a similar experimental study was used to examine the preventive and control measures of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation (ICU). Patients from May to July 2015 who used the checklist as intervention group, and patients from January to March 2015 who did not use the checklist were used as control group. The total implementation rate of preventive and control measures for ventilator-associated pneumonia was compared between the two groups. Single execution rate and incidence of ventilator-associated pneumonia. Results the overall implementation rate of ventilator associated pneumonia prevention and control measures was increased (31.8%vs 54.5%) and the incidence of ventilator-associated pneumonia was significantly decreased (34.2 鈥，

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