呼吸机集束化护理升级对促进重症监护病房护士依从性及减少患者呼吸机相关性肺炎的效果

Effect of nursing care of ventilator bundle on promoting compliance of ICU nurses and reducing ventilator-associated pneumonia in patients

目的探讨在重症监护病房(ICU)护理中运用呼吸机集束化护理升级方案对ICU护士依从性的影响,同时观察其对呼吸机相关性肺炎发生情况的作用效果。方法纳入该院ICU病房进行机械通气的患者100例,将其随机分为观察组和对照组,每组各50例,观察组在机械通气的基础上实行呼吸机集束化护理升级护理措施,对照组在机械通气基础上进行ICU的常规护理,待患者撤机后,对比两组护理人员双手清洁、口腔护理、体位护理、呼吸机管路护理和冷凝水更换的频次以评价其依从性,同时观察两组患者机械通气时间、住院总天数的差异及呼吸机相关性肺炎的发生情况。结果经过呼吸机集束化升级护理干预后,观察组ICU护士的依从性明显高于对照组,比较差异有统计学意义(P<0.05);观察组患者的机械通气时间及住院总天数短于对照组,比较差异有统计学意义(P<0.05);呼吸机相关性肺炎发生率显著低于对照组,比较差异有统计学意义(P<0.05)。结论对ICU进行机械通气的患者施以呼吸机集束化护理升级,能够增强病区护理人员的依从性,减少呼吸机相关性肺炎的发生,有利于综合地提升护理质量,改善临床的疗效。

【Objective】To explore the influence of nursing care of ventilator bundle on the compliance of intensive care unit（ICU） nurses in ICU nursing,and to observe its effect on the occurrence of ventilator-associated pneumonia.【Methods】One hundred patients treated with mechanical ventilation in the ICU ward of our hospital were included,and were randomly divided into observation group and control group,with 50 cases in each group.Observation group carried on ventilator bundle nursing measures on the basis of mechanical ventilation,and the routine nursing care of ICU was performed on the basis of mechanical ventilation in the control group.After the weaning of patients,personnel hand cleanliness of nurses in the two groups,the frequency of oral care,body care,ventilator tube nursing,condensed water replace of the two groups were compared to evaluate its compliance,and the differences in mechanical ventilation time,total hospital days and the occurrence of ventilator-associated pneumonia were observed in the two groups.【Results】After ventilator bundle nursing,ICU nurses compliance of the observation group was significantly higher than that of the control group（P〈0.05）,mechanical ventilation time and hospitalized days of patients in the observation group were shorter than the control group（P〈0.05）,and the incidence of ventilator-associated pneumonia of the observation group was significantly lower than that of the control group（P〈0.05）.【Conclusion】The application of ventilator bundle care in ICU patients with mechanical ventilation,can enhance the compliance of nursing staff in the wards and reduce the incidence of ventilatorassociated pneumonia,comprehensively promote the nursing quality and improve clinical curative effect.