耐药鲍氏不动杆菌感染患者的临床护理管理

Clinical nursing management of patients with resistant Acinetobacter baumannii infection

目的通过对神经内科住院患者耐药鲍氏不动杆菌的临床感染分析,采取相关的专科护理措施及对该类患者的临床管理,探讨住院患者耐药鲍氏不动杆菌感染的临床护理管理的有效性。方法调查2014年9月-2015年1月收治的5例耐药鲍氏不动杆菌感染患者临床资料,加强患者的消毒隔离管理及医务人员的手卫生,防止同病房、同病区的交叉感染。结果 5例感染患者住院4周内,检测分离出16株病原菌,其中耐药鲍氏不动杆菌9株,占56.3%,均从痰液中检出;通过有效的护理、管理措施,患者至出院前,均无耐药鲍氏不动杆菌检出;患者住院期间,感染控制管理及时,病区符合卫生学检测标准,对病区环境、空气、医务人员的手进行细菌监测,检出菌落数均控制在正常范围内,且未检出耐药鲍氏不动杆菌及其他致病微生物;护理管理有效,无交叉感染的发生。结论严格执行消毒隔离措施,加强独立的床单元、病房单元的管理,加强医务人员、患者、家属手卫生可有效控制感染,防止感染的暴发流行。

OBJECTIVE Through analyzing clinical infection of Acinetobacter baumannii in neurological inpatients and taking special nursing measures and clinical management for this kind of patients,to discuss the effectiveness of clinical nursing management of patients with resistant A.baumanniiinfection.METHODS Clinical data of 5cases of resistant A.baumannii infection during Sep.2014 to Jan.2015 were investigated.The disinfection and isolation management of patients as well as hand hygiene of the medical staff were strengthened to prevent cross infection in the same ward and the same endemic area.RESULTS During the 4-week hospitalization of the 5infected patients,16 pathogens were detected including 9resistant A.baumannii strains accounting for 56.3%,all cultured from sputum.After effective nursing and management,no resistant A.baumannii strains were detected before discharge.During hospitalization,the infection control and management was in a timely manner,the ward was in accorded with the hygienic standards.The bacterial test of the environment in the ward,the air and hands of medical staff showed the positive colonies were in the normal range,and no resistant A.baumannii and other pathogenic microorganisms were detected.The nursing management was effective without occurrence of cross infection.CONCLUSIONStrict implementation of disinfection and isolation measures and strengthening of independent management of bed unit and ward as well as the hand hygiene of medical staff,patients and patient family can effectively prevent the outbreak of infection.