追踪法方案对预防ICU气管插管非计划性拔管的效果研究

Effect of Tracking Method on Preventing Unplanned Extubation of ICU Tracheal Intubation

目的:探究追踪法方案对预防ICU气管插管非计划性拔管(UEX)的效果。方法:选取2015年7月-2016年6月本院ICU病房住院的气管插管患者100例。按照随机数字表法将其分为对照组和观察组,各50例。对照组采用常规护理方法,观察组在对照组基础上采用追踪法护理。比较两组护士相关知识、行为得分,比较两组UEX发生率及其因素、护理满意度。结果:观察组护士UEX知识、临床行为得分均高于对照组,比较差异均有统计学意义(P<0.05);观察组UEX发生率为4.0%,低于对照组的16.0%(P<0.05);对照组患者发生管路滑脱因素有约束不当、躁动镇静不足、固定无效、观察巡视不到位,而观察组主要是约束不当和躁动镇静不足;两组患者均没有患者自行拔除的情况,对照组患者发生管路滑脱因素明显多于观察组,但比较差异均无统计学意义(P>0.05);而且观察组对护理的满意度高于对照组(P<0.05)。结论:追踪法进行导管护理观察的方法能及时准确的观察导管的留置长度、固定效果及早期导管滑脱迹象等情况,能提高护士防脱管风险管理意识和防脱管护理知识水平,降低脱管风险和UEX发生率,可以有效地预防UEX的发生。

Objective:To explore the effect of tracking method on preventing unplanned extubation of ICU tracheal intubation.Method:A total of 100 patients with tracheal intubation hospitalized in ICU from July 2015 to June 2016 were selected.According to the random number table method,they were divided into control group and observation group,50 cases in each group.The control group was treated with routine nursing,while observation group was treated with tracking method nursing on the basis of control group.The nurses’knowledge and behavior scores of two groups were compared,the incidence of UEX and its factors and nursing satisfaction were compared between two groups.Result:The scores of UEX knowledge and clinical behavior of nurses in observation group were higher than those of control group,the difference were statistically significant(P<0.05).The incidence of UEX in observation group was 4.0%,which was lower than 16.0%in control group(P<0.05).The patients in control group suffered from improper tube slippage,lack of restlessness,lack of fixation,and poor observation,while observation group was mainly constrained by improper and restless sedation,and two groups of patients did not have their own extraction,the incidence of slippage in control group was higher than that of observation group,but the difference was not statistically significant(P>0.05).The nursing satisfaction of observation group was higher than that of control group(P<0.05).Conclusion:The tracking method can observe the length of the catheter in time,the fixation effect and the early catheterization of catheterization,can improve the risk management awareness and nursing knowledge level of prevention of off-tube,reduce the risk of off-tube and the incidence of UEX,and can effectively prevent the occurrence of UEX.