综合干预措施对ICU医务人员呼吸机集束化策略执行率与呼吸机相关肺炎发病率的影响
发布时间：2018-09-12 12:43
【摘要】：目的通过对重症监护病房(ICU)机械通气患者进行呼吸机集束化策略(VCB)干预,并利用综合措施提高医护人员对VCB的执行率,降低呼吸机相关肺炎(VAP)的发生率。方法采取整群抽样的方法,分别选取2015年5-7月和2015年9月-2016年8月入住重症ICU且行机械通气≥48h的患者37例和151例,分为干预前组和干预后组;基线调查结束后,通过问卷调查找出综合ICU医护人员对VCB不执行的原因,采取综合干预措施后比较两组医护人员对机械通气患者VCB的执行率及患者VAP发生率,评价干预效果。结果 ICU医护人员中认为VAP是可预防的仅占43.5%,对各项防控措施的知晓率为21.7%~52.2%,所有人员均认为表格繁琐是VAP防控措施未执行的主要原因;干预前后患者呼吸机使用率分别为26.8%和28.1%,差异无统计学意义;干预前VCB整体执行达标率为19.2%,干预后达到76.5%;床头抬高30~45°、每日拔管撤机评估、洗必泰口腔护理、气囊压力≥20cmH_2O和手卫生的执行达标率干预前与干预后比较差异有统计学意义(P0.05)。结论 ICU医护人员对VAP防控措施知晓率及规范执行率较低,综合措施可提高ICU医护人员对患者VCB的执行率,降低VAP发病率,但呼吸机使用率未见显著降低。
[Abstract]:Objective to improve the implementation rate of (ICU) in intensive care unit (ICU) by (VCB) intervention of ventilator cluster strategy, and to reduce the incidence of ventilator-associated pneumonia (VAP). Methods by cluster sampling, 37 and 151 patients admitted to severe ICU from May to July 2015 and from September 2015 to August 2016 were divided into pre-intervention group and post-intervention group. Through the questionnaire survey to find out the reason why the comprehensive ICU medical staff do not carry out the VCB, after taking the comprehensive intervention measure, compare the execution rate of VCB and the incidence of VAP of the patients with mechanical ventilation between the two groups of medical and nursing staff, and evaluate the effect of the intervention. Results among the medical staff of ICU, only 43.5% believed that VAP was preventable, and the awareness rate of various preventive and control measures was 21.7% and 52.2%. All the staff thought that the tedious form was the main reason why the preventive and control measures of VAP were not carried out. Before and after intervention, the utilization rate of ventilator was 26.8% and 28.1respectively, there was no significant difference between the two groups, before and after the intervention, the overall rate of VCB reached the standard of 19.2and reached 76.5g after the intervention, the bed head was raised 3045 掳, the daily extubation and withdrawal machine was evaluated, and the oral care of chlorhexidine was taken out. Air bag pressure 鈮，
本文编号：2239038
[Abstract]:Objective to improve the implementation rate of (ICU) in intensive care unit (ICU) by (VCB) intervention of ventilator cluster strategy, and to reduce the incidence of ventilator-associated pneumonia (VAP). Methods by cluster sampling, 37 and 151 patients admitted to severe ICU from May to July 2015 and from September 2015 to August 2016 were divided into pre-intervention group and post-intervention group. Through the questionnaire survey to find out the reason why the comprehensive ICU medical staff do not carry out the VCB, after taking the comprehensive intervention measure, compare the execution rate of VCB and the incidence of VAP of the patients with mechanical ventilation between the two groups of medical and nursing staff, and evaluate the effect of the intervention. Results among the medical staff of ICU, only 43.5% believed that VAP was preventable, and the awareness rate of various preventive and control measures was 21.7% and 52.2%. All the staff thought that the tedious form was the main reason why the preventive and control measures of VAP were not carried out. Before and after intervention, the utilization rate of ventilator was 26.8% and 28.1respectively, there was no significant difference between the two groups, before and after the intervention, the overall rate of VCB reached the standard of 19.2and reached 76.5g after the intervention, the bed head was raised 3045 掳, the daily extubation and withdrawal machine was evaluated, and the oral care of chlorhexidine was taken out. Air bag pressure 鈮，
本文编号：2239038
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