护理人员系统化培训对预防呼吸机相关性肺炎的影响

Impact of systematic training of nursing staff on prevention of incidence of ventilator-associated pneumonia

目的评估护理人员系统化培训及综合管理对降低呼吸机相关性肺炎(VAP)的发生率的价值。方法选取复旦大学附属肿瘤医院ICU2011年1月-2012年12月接受机械通气的患者作为研究对象,将干预前(2011年1-12月)的120例患者作为对照组,实施系统化培训及综合管理期间(2012年1-12月)的126例患者作为干预组,比较干预前后两组VAP发生率的变化。结果 2012年1-12月共有48名护理人员参与了预防VAP的系统培训,系统培训完成率95.00%;2011年1-12月接受机械通气总天数为523d,全年呼吸机相关性肺炎发生率为21.03‰,系统培训及综合干预后,2012年1-12月接受机械通气总天数为959d,全年呼吸机相关性肺炎发生率为8.34‰,呼吸机相关性肺炎发生率下降了60.80%,两者比较差异有统计学意义(P<0.05)。结论针对ICU护理工作人员的系统化教育能显著降低呼吸机相关性肺炎的发生率,降低呼吸机相关性肺炎的发生需要呼吸系统治疗医师和ICU护理人员的共同协作。

OBJECTIVE To assess the value of systematic training and comprehensive management of the nursing staff on reduction of incidence of ventilator-associated pneumonia（VAP）.METHODS The patients who underwent the mechanical ventilation in the ICU of FUSCC between Jan 2011and Dec 2012were enrolled in the study,then the 120patients from who the nursing staff did not take interventions（from Jan to Dec 2011）were assigned as the control group,the 126patients for whom the nursing staff implemented the systematic training and comprehensive management（from Jan to Dec 2012）were set as the intervention group,and the change of incidence of VAP was observed and compared between the two groups before and after the interventions.RESULTS Totally 48nursing staff participated the systematic training for prevention of VAP between Jan and Dec 2012,and 95.00%finished the systematic training.The overall duration of the mechanical ventilation was 523days from Jan to Dec 2011,and the incidence of VAP was 21.03‰in the whole year.After the implementation of the systematic training and comprehensive interventions,the overall duration of mechanical ventilation was 959days from Jan to Dec 2012,and the incidence of VAP was 8.34‰in the whole year,with a decrease of 60.80%,the difference between the two groups was significant（P＆lt;0.05）.CONCLUSION The targeted systematic training for the ICU nursing staff can significantly reduce the incidence of VAP;the doctors in charge of the treatment of respiratory diseases and the nursing staff should collaborate to reduce the incidence of VAP.