FOCUS-PDCA评估模式对于慢性阻塞性肺疾病伴呼吸衰竭患者人工气道管理的价值

The value of FOCUS-PDCA assessment model for artificial airway management in patients with chronic obstructive pulmonary disease and respiratory failure

目的探讨FOCUS-PDCA评估模式对于慢性阻塞性肺疾病伴呼吸衰竭患者人工气道管理的价值。方法选择2017年6月10日—2021年6月10日本院收治的110例慢性阻塞性肺疾病伴呼吸衰竭行人工气道的患者作为研究对象,随机分为干预组和对照组两组,每组各55例。对照组患者进行常规人工气道管理,干预组患者采用FOCUS-PDCA评估模式对患者进行人工气道管理。对比两组患者护理效果、护理干预后人工气道湿化满意率;气囊压力合格率、床头抬高合格率、机械通气时间及住院时间、两组患者血氧分压(PaO_(2))及二氧化碳分压(PaCO_(2))变化情况、医护人员操作落实情况、两组患者人工气道并发症发生情况及护理满意度。结果干预组护理效果明显优于对照组(P<0.05);干预后,干预组患者人工气道湿化满意度评分、气囊压力合格度评分、床头抬高合格度评分均明显高于对照组,机械通气时间及住院时间均明显短于对照组(P<0.05);干预后,干预组PaO_(2)水平明显高于对照组,PaCO_(2)明显低于对照组(P<0.05);干预组医护人员操作落实情况明显优于对照组(P<0.05);干预组并发症发生率为3.64%;对照组并发症发生率为18.18%;干预组护理满意度为94.55%,对照组护理满意度为63.64%,两组患者并发症发生率及护理满意度对比均有显著差异(P<0.05)。结论将FOCUS-PDCA评估模式应用于慢性阻塞性肺疾病伴呼吸衰竭患者人工气道管理中,能够使医护人员的人工气道操作更加规范,提升医护人员工作质量的同时也提高了护理效果与护理满意度,对促进患者恢复与降低并发症发生率具有积极意义,应用价值较高。

Objective To explore the value of FOCUS-PDCA assessment model for artificial airway management in patients with chronic obstructive pulmonary disease and respiratory failure.Methods Selecting 110 patients with chronic obstructive pulmonary disease and respiratory failure who underwent artificial airway in our hospital from June 10,2017 to June 10,2021 as the research objects,and all patients were randomly divided into intervention groups and the control group,55 patients in each group.Patients in the control group were given routine artificial airway management,and the intervention group was given the FOCUS-PDCA assessment model for artificial airway management for the patients.The care effect of the two groups of patients,satisfaction rate of the artificial airway humidification after the intervention,qualified rate of airbag pressure,qualified rate of bed head elevation,mechanical ventilation time and length of hospitalization,changes in blood oxygen partial pressure and carbon dioxide partial pressure of the two groups of patients,the implementation of medical staff,and complications of the artificial airway and nursing satisfaction of the two groups of patients were compared.Results The nursing effect of the intervention group was significantly better than that of the control group(P<0.05).After the intervention,the artificial airway humidification satisfaction score,airbag pressure qualification score,and bedside elevation qualification score of the intervention group were significantly higher than those of the control group,however,the mechanical ventilation time and hospital stay were significantly shorter than those of the control group(P<0.05).After the intervention,the PaO_(2) level of the intervention group was significantly higher than that of the control group,and PaCO_(2) was significantly lower than the control group(P<0.05).The implementation status of medical staff in the intervention group was significantly better than the control group(P<0.05);the complication rate of the intervention group was 3.64%,the complication rate of the control group was 18.18%;the nursing satisfaction rate of the intervention group was 94.55%,and the nursing satisfaction rate of the control group was 63.64%.There were significant differences in the complication rate and nursing satisfaction between the two groups(P<0.05).Conclusions Applying the FOCUS-PDCA assessment model to the artificial airway management of patients with chronic obstructive pulmonary disease and respiratory failure could make the artificial airway operation of medical staff more standardized,improve the quality of medical staff's work,and improve the effectiveness of patient care and nursing satisfaction,it has a positive meaning in promoting the recovery of patients and reducing the incidence of complications.It performs high application value.