JCI理念指导下的集束化护理模式对肺心病合并呼吸衰竭机械通气患者的影响

Effect of cluster nursing mode under the guidance of JCI concept on patients with pulmonary heart disease complicated with respiratory failure undergoing mechanical ventilation

目的探讨国际医疗卫生机构认证联合委员会(JCI)理念指导下的集束化护理模式在肺心病合并呼吸衰竭机械通气患者中的应用效果。方法回顾性收集南阳医学高等专科学校第一附属医院2019年1月至2021年1月肺心病合并呼吸衰竭机械通气患者80例, 按照护理方法分为对照组(39例)和研究组(41例)。对照组男25例, 女14例, 年龄(48.74±8.06)岁;研究组男28例, 女13例, 年龄(50.03±7.62)岁。对照组采取常规护理, 研究组在对照组基础上采取JCI理念指导下的集束化护理模式。比较两组患者康复进程、护理效果及家属护理工作满意度。结果研究组机械通气时间、ICU停留时间、住院时间分别为(10.38±2.25)d、(11.58±2.67)d、(15.87±1.64)d, 均短于对照组(12.67±3.05)d、(13.97±3.14)d、(19.24±2.35)d, 差异均有统计学意义(均P<0.05)。研究组呼吸机相关性肺炎(VAP)、气道损伤、口腔溃疡、腹胀发生率分别为4.88%(2/41)、2.44%(1/41)、2.44%(1/41)、7.32%(3/41), 均低于对照组23.08%(9/39)、25.64%(10/39)、23.08%(9/39)、30.77%(12/39), 差异均有统计学意义(均P<0.05)。研究组家属护理工作满意度为92.68%(38/41), 高于对照组74.36%(29/39), 差异有统计学意义(χ^(2)=4.931, P<0.05)。结论相较于集束化护理模式, JCI理念指导下的集束化护理模式可进一步加速肺心病合并呼吸衰竭机械通气患者康复进程, 减少VAP等并发症发生率, 同时能提升家属的护理工作满意度。

Objective To explore the application effect of cluster nursing mode under the guidance of Joint Commission International(JCI)concept on patients with pulmonary heart disease complicated with respiratory failure undergoing mechanical ventilation.Methods A total of 80 patients with pulmonary heart disease complicated with respiratory failure undergoing mechanical ventilation in The First Affiliated Hospital of Nanyang Medical College from January 2019 to January 2021 were divided into two groups according to the nursing methods.There were 25 males and 14 females in the control group,aged(48.74±8.06)years;there were 28 males and 13 females in the study group,aged(50.03±7.62)years.The control group took routine nursing,and the study group took cluster nursing mode under the guidance of JCI concept on the basis of the control group.The rehabilitation process,nursing effect,and nursing job satisfaction of family members were compared between the two groups.Results The duration of mechanical ventilation,ICU stay,and hospital stay in the study group were(10.38±2.25)d,(11.58±2.67)d,and(15.87±1.64)d,respectively,which were shorter than those in the control group[(12.67±3.05)d,(13.97±3.14)d,and(19.24±2.35)d],with statistically significant differences(all P<0.05).The incidences of ventilator associated pneumonia(VAP),airway injury,oral ulcers,and abdominal distension were 4.88%(2/41),2.44%(1/41),2.44%(1/41),and 7.32%(3/41),respectively,which were lower than those in the control group[23.08%(9/39),25.64%(10/39),23.08%(9/39),and 30.77%(12/39)],with statistically significant differences(all P<0.05).The nursing satisfaction of family members in the study group was 92.68%(38/41),which was higher than that in the control group[74.36%(29/39)],with a statistically significant difference(χ^(2)=4.931,P<0.05).Conclusions Compared with the cluster nursing mode,the cluster nursing mode under the guidance of JCI concept can further accelerate the rehabilitation process of patients with pulmonary heart disease complicated with respiratory failure undergoing mechanical ventilation,reduce the incidence of complications such as VAP,and improve the nursing work satisfaction of family members.