应用查检表对ICU医护合作预防呼吸机相关性肺炎的效果观察

The application effect of ICU checklist of medical cooperation to prevent ventilator-associated pneumonia

目的 探讨应用查检表对ICU医护合作预防呼吸机相关性肺炎的效果观察.方法 将2015年7月至2016年7月收治728例机械通气的患者作为试验组,采用查检表,将2014年6月至2015年6月收治685例机械通气的患者作为对照组,未采用查检表,比较2组呼吸机相关性肺炎发生情况、医护合作情况.结果 应用查检表前后呼吸机相关性肺炎发生率分别为6.72%（46/685）和3.02%（22/728）,干预策略执行率分别为63.36%（434/685）和84.89%（618/728）,2组比较差异有统计学意义（χ2=10.51、86.03,均P〈0.01）;应用查检表前医护合作及满意度情况评分分别为（18.53±2.39）、（21.91±2.16）、（30.93±2.18）分,应用查检表后分别为（26.71±2.21）、（28.64±2.55）、（45.33±1.74）分,2组比较差异有统计学意义（t=6.14、14.25、2.39,P〈0.01或0.05）.结论 应用查检表能提高医护合作对预防呼吸机相关性肺炎的管理效果,降低呼吸机相关性肺炎的发生率,改善医护合作情况,提高医护满意度,提高管理效能,值得推广应用.

Objective To explore the application effect of ICU checklist of medical cooperation on prevention of ventilator-associated pneumonia. Methods Totally 728 patients with mechanical ventilation from July 2015 to July 2016 in ICU were assigned to the experimental group with using of the checklist; and 685 patients with mechanical ventilation from June 2014 to June 2015 were set as the control group who did not use the checklist. The incidence of ventilator-associated pneumonia and medical cooperation were compared before and after the implementation of the checklist. Results The incidence of ventilator associated pneumonia were 6.72% （46/685） and 3.02% （22/728）, the intervention strategy execution rates were 63.36% （434/685） and 84.89% （618/728） before and after the application of checklist, there was significant difference between two groups （χ2=10.51, 86.03, P〈0.01）. Medical cooperation （doctors and nurses） and satisfaction scored 18.53 ± 2.39, 21.91 ± 2.16, 30.93 ± 2.18 and 26.71 ± 2.21, 28.64 ± 2.55, 45.33 ± 1.74 before and after the application of checklist, there was significant difference between two groups （t=6.14, 14.25, 2.39, P〈0.01 or 0.05）. Conclusions The application of checklist can improve the medical cooperation on prevention of ventilator-associated pneumonia management, reduce the incidence of ventilator-associated pneumonia, improve medical cooperation, nursing satisfaction and the management efficiency, which is worthy of popularization and application.