ICU护士对呼吸机集束化干预措施的知晓及执行情况调查

A survey of ICU nurses' awareness and implementation of ventilator cluster intervention

目的：了解医院ICU护理人员呼吸机集束化干预措施知识的知晓及执行现状,以期能找到实施呼吸机集束化干预措施工作中不足,为ICU的临床护理工作提供更加科学的参考依据。方法：2015年9-12月采用自行设计的问卷,对我市的4所三级综合医院的213名ICU护士进行调查。结果：呼吸机集束化干预措施知识知晓率在90.00%以上的为定时对患者进行胸肺部物理治疗、病情允许下机械通气患者应抬高床头（30°-45°）;知晓率在60.00%以下的为声门下分泌物引流、预防深静脉血栓;执行率在90.00%以上的为每日唤醒计划及拔管试验、预防消化性溃疡;执行率在60.00%以下的为机械通气患者按要求完成口腔护理,口腔护理大于每日4次、预防深静脉血栓。结论：ICU护理人员呼吸机集束化干预措施部分知识尚可,需要进行医护合作的知识较欠缺;需要进行医护合作的集束化干预措施的执行情况尚可,但那些耗时的集束化干预措施的执行率较低,ICU在呼吸机集束化干预部分措施的执行方面尚需加强。

Objective： To understand the knowledge and implementation status of the ICU nursing staffs towards the ventilator cluster intervention,so as to find out the insufficiency in the implementation of the ventilator cluster intervention work and to provide more scientific reference for ICU clinical nursing work. Methods： A total of 213 ICU nurses from four tertiary general hospitals in our city were investigated by self-designed questionnaires from September2015 to December 2015. Results： The awareness rate of the ventilator cluster interventions which was more than 90. 00% were the nurses who treated the patients with thoracic lung physiotherapy regularly. If the situation allowed,patients under the condition of mechanical ventilation should raise the bed by 30° ~ 45° at the head. Awareness rate below 60. 00% were the nurses who were responsible for subglottic secretions drainage and prevention of deep vein thrombosis. The implementation rates which were above 90. 00% mainly focused on the daily wake-up plan and extubation test as well as the prevention of peptic ulcer. The implementation rate of 60. 00% or less mainly focused on patients with mechanical ventilation required to complete oral care and the times of oral care were greater than 4 times a day as well as prevention of deep vein thrombosis. Conclusion： The knowledge of ICU nursing staff towards the ventilator cluster interventions are not bad,while the knowledge which in need for health care collaboration between doctors and nurses is poor. The implementation of cluster interventions that require health care collaboration between doctors and nurses is acceptable,but implementation rate of time-consuming clustered interventions is low. ICU staff still need to strengthen the the implementation of some measures of ventilator cluster intervention.