集束干预策略对预防呼吸机相关肺炎的临床研究

The clinical study of cluster intervention strategies for the prevention of ventilator associated pneumonia

目的探讨多准则决策分析法构建的集束干预策略对呼吸机相关肺炎发生率的影响。方法选择2009年11月～2010年11月在ICU入住的患者60例,随机分为实验组和对照组,各30例。实验组实施集束干预策略,对照组实施常规护理。比较两组VAP发生率、死亡率、机械通气时间、入住ICU时间、ICU期间住院费用、护理人员依从性差异。结果实验组洗手、抬高床头依从性(96.7%,100%)显著高于对照组(57.2%,44.7%);实验组VAP发生率,机械通气时间,入住ICU时间低于对照组,差异均有显著意义(P<0.05)。结论科学构建的集束干预策略预防VAP效果较好,提高了护士依从性,能有效落实指南并改善患者预后,值得临床应用。

Objective To study the effect of cluster intervention strategies by multi-standard based decision making for patients with ventilator associated pneumonia（VAP）. Method 60 cases hospitalized patients in ICU department from November 2009 to November 2010 were selected and randomly divided into experimental group（30 patients） and control group（30 patients）.Patients in experimental group was given cluster intervention,and patients in control group was given routine interventions.The of incidence of VAP,time of mechanical ventilation and stay in ICU as well as the compliance of nurses were observed and compared. Result Compliance of nurses in hand washing and bed rising was 96.7% and 100% in experimental group,It＇s higher than that of in the control group（57.2% and 44.7%）.The incidence of VAP,time of mechanical ventilation and staying in ICU was much lower than that of in control group.There was significantly difference between the two group（P0.05）. Conclusion Scientific based cluster intervention strategies can effectively prevent VAP,improve compliance of nurses,carry out the guidelines in clinical practice and improve patients＇ prognosis.It＇s valuable for promotion.