品质管理活动对降低ICU患者呼吸机相关性肺炎的影响研究

Effect of quality management activity on reduction of incidence of ventilatorassociated pneumonia in ICU patients

目的研究品质管理活动对ICU患者呼吸机相关性肺炎的影响,以降低医院感染发生率,提高护理质量。方法科室于2013年3月份成立品质管理活动小组,调查96例患者需要改善的问题,通过对现况问题的要因分析,确定并落实了3项重要的改进措施,数据采用SPSS 17.0软件进行统计分析。结果 96例患者共调查450例次检查项目,以呼吸机管路管理缺失为主,共204个占45.33%;呼吸机相关性肺炎的千日感染率由活动前的25.13‰下降至活动后13.39‰;由于科室首次开展品质管理活动,对能力估计不足,目标过于理想化,未达到预期目标9.71‰。结论品质管理活动的开展有效的降低了ICU患者呼吸机相关性肺炎的发生率,提高医院感染综合管理水平的同时也提高了护理质量,降低了病死率。

OBJECTIVE To observe the impact of quality management activity on ventilator-associated pneumonia in the ICU patients so as to reduce the incidence of nosocomial infections and improve the nursing quality. METHODS The team in charge of the quality management activity was set up in the departments in Mar 2013, the problems of 96 patients that needed to be improved were investigated, the causal factor analysis was conducted for the existing problems so as to determine three major improvement measures, and the statistical analysis of data was performed with the use of SPSS 17.0 software. RESULTS A total of 450 case-times of items were investigated, involving 96 patients, and absence of management of ventilator pipelines was dominant, accounting for 45.33% （204）. The thousand-day infection rate of the ventilator-associated pneumonia dropped from 25. 13%0 before the activity to 13.39%o after the activity. Because it was the first time for the department to conduct the quality management ac- tivity, overestimation of capability leading to the idealized goal, 9. 71% of the expected goal was never reached. CONCLUSION The conduct of the quality management activity has effectively reduced the incidence of veritilator- associated pneumonia in the ICU patients, improved the level of integrated management of nosocomial infections as well as the quality of nursing, and reduced the mortality.