集束化护理在预防呼吸机相关性肺炎中的作用及对护理质量和满意度的影响

Role of cluster nursing in preventing ventilator associated pneumonia and its effect on nursing quality and patients' satisfaction

目的探讨集束化护理在预防呼吸机相关性肺炎(VAP)中的作用及对护理质量和满意度的影响。方法选取2016年7月至2017年1月我院重症监护室(ICU)实施集束化护理前收治的行机械通气患者56例作为对照组,选取2017年5—11月我院ICU实施集束化护理后收治的行机械通气患者56例作为观察组。对比两组患者VAP发生率、病死率、机械通气时间、ICU入住时间、总住院时间、血气分析指标变化情况、患者满意度及护理质量。结果观察组VAP发生率及病死率均较对照组低(P<0.05);观察组机械通气、ICU入住及总住院时间均较对照组短(P<0.05);观察组PaO_2测定值高于对照组(P<0.05),PaCO_2测定值低于对照组(P<0.05);观察组各项护理质量评分均较对照组高(P<0.05);观察组患者满意度较对照组高(P<0.05)。结论集束化护理对VAP起到有效预防作用,同时可改善患者血气分析指标,提高护理质量及患者对护理工作的满意度。

Objective To explore the role of cluster nursing in preventing ventilator associated pneumonia（VAP） and its effect on nursing quality and patients＇ satisfaction. Methods To select 56 cases of patients with mechanical ventilation who were admitted to the intensive care unit（ICU） in our hospital from July 2016 to January 2017 as the control group before the implementation of cluster care,and to select 56 cases of patients with mechanical ventilation who were admitted to the intensive care unit（ICU） in our hospital from May 2017 to November 2017 as the observation group after the implementation of cluster nursing. The incidence of VAP,mortality,mechanical ventilation time,ICU admission time,total length of stay,change in blood gas analysis index,patient satisfaction,and quality of care were compared between the two groups. Results The incidence and mortality of VAP in the observation group were lower than that in the control group（P 〈 0. 05）. The mechanical ventilation,ICU admission,and total length of stay in the observation group were shorter than those in the control group（P 〈 0. 05）. The observation value of PaO_2 in the observation group was higher than that in the control group（P 〈 0.05）,and the PaCO_2 measurement value was lower than that of the control group（P 〈 0. 05）. The nursing quality scores in the observation group were all higher than those in the control group（P 〈 0. 05）. In addition,the patient satisfaction in the observation group was higher than that in the control group（P 〈 0. 05）. Conclusion Cluster nursing can effectively prevent VAP. Meanwhile,it can improve blood gas analysis index and nursing quality and patients＇ satisfaction with nursing work.