摘要
目的提高ICU护士实施呼吸机辅助呼吸患者集束化护理依从性,降低呼吸机相关性肺炎(VAP)发生率。方法将60例机械通气患者按时间段分为两组各30例;对照组在呼吸机集束化护理过程中实施常规管理,观察组对存在的问题进行针对性管理,包括成立集束化护理小组、对ICU护士培训、调整人力、视觉强化、质量监控等措施。结果护士洗手、抬高床头、呼吸机管路的更换、冷凝水的倾倒及口腔护理的依从性显著提高(均P<0.01);观察组VAP发生率显著低于对照组(P<0.01)。结论实施呼吸机集束化护理专项管理有利于提高护理人员的依从性,降低VAP发生率。
Objective To improve ICU nurses′compliance with ventilator care bundles and to reduce ventilator-associated pneumonia（VAP）.Methods Sixty patients with mechanical ventilation were assigned either to an observation group（30cases）or a control group（30cases）according to chronological order.The control group was given routine management during implementation of care bundles,while the observation group received interventions that formulated to solve the problems in the control group,including building a team for providing care bundles,educating nurses,adjusting human resource,giving visual reinforcement,and conducting quality monitoring.Results Nurses′compliance with hand washing,elevation of the head of the bed,replacement of ventilator circuit,pouring out the condensated water,and oral care was significantly increased（P0.01 for all）.The incidence of VAP in the observation group was significantly lower than the control group（P0.01）.Conclusion The management specific to ventilator care bundles is helpful to improve compliance of nursing staff,and to reduce VAP.
关键词
ICU
呼吸机辅助呼吸
集束化护理
依从性
呼吸机相关性肺炎
护理管理
intensive care unit
ventilator assisted breathing
care bundles
compliance
ventilator associated pneumonia
nursing management
