循证护理在控制机械通气患者呼吸机相关性肺炎中的应用

Application of evidence-based nursing in control of ventilator-associated pneumonia in patients with mechanical ventilation

目的探讨循证护理在控制机械通气患者呼吸机相关性肺炎(VAP)中的应用效果。方法收集160例机械通气患者按是否愿意接受循证护理干预分为2组,对照组给予常规护理,实验组加施循证护理,比较2组患者每日接受相关护理措施情况、相关临床指标与所受护理工作量、VAP与护理不良事件发生情况、满意度调查结果等。结果实验组患者每日接受插管固定评估、插管深度评估、气囊压力评估、口腔清洁处理、镇静镇痛处理与吸痰拍背处理率显著高于对照组(P<0.01);实验组患者有创通气时间、总机械通气时间、住院时间显著短于对照组,NAS评分显著高于对照组(P<0.01);实验组患者非计划拔管、VAP与投诉的发生率显著低于对照组(P<0.05);实验组患者护理满意情况显著优于对照组(P<0.01)。结论循证护理在控制机械通气患者呼吸机相关性肺炎中的应用效果显著,可提高满意度,具有借鉴性。

Objective To investigate the effect of evidence-based nursing in control of ventilator-associated pneumonia（ VAP） in patients with mechanical ventilation. Methods A total of 160 patients with mechanical ventilation were divided into two groups. The control group was treated with routine nursing,while the experimental group was given evidence-based nursing. Related nursing measures,related clinical indicators and the nursing workload,VAP and the incidence rate of adverse events and satisfaction degree were compared between two groups. Results The assessment of intubation fixation,assessment of intubation depth,airbag pressure evaluation,oral cleaning,processing rates of sedation and analgesia as well as suction burp in the experimental group were significantly higher than those in the control group（ P〈0. 01）. The invasive ventilation time,the total time of mechanical ventilation and hospital stay in the experimental group were significantly shorter than those in the control group,and NAS score was significantly higher than the control group（ P〈0. 01）. The incidence rates of unplanned extubation,VAP and complaints in the experimental group were significantly lower than those in the control group（ P〈0. 05）. Nursing satisfaction degree in the experimental group was significantly better than that in the control group（ P〈0. 01）. Conclusion Evidence-based nursing can significantly improve satisfaction degree in mechanical ventilation patients with ventilator-associated pneumonia.