院前院内一体化管理对降低AIS患者误吸及坠积性肺炎发生率的效果

Effect of integrated pre- and in-hospital management on reducing the incidence of aspiration and hypostatic pneumonia in patients with acute ischemic stroke

目的探讨院前院内一体化管理对降低急性缺血性脑卒中(AIS)患者误吸及坠积性肺炎发生率的效果。方法选取2020年3月—2021年10月某院诊治的108例AIS患者,根据干预时间、管理模式不同,将2020年3—12月接受院内常规护理操作的55例AIS患者列为对照组,2021年1—10月接受院前院内一体化管理的53例AIS患者列为干预组,比较两组AIS患者误吸及坠积性肺炎发生率、平均住院时间、患者满意度,以及两组AIS患者的医生和护士感染防控及气道管理知识考核得分、手卫生依从率的差异。结果干预组AIS患者误吸与坠积性肺炎发生率(分别为9.43%、3.77%)均低于对照组(分别为25.45%、14.55%);干预组平均住院时间短于对照组[(10.79±5.35)d VS(13.69±6.84)d],患者满意度高于对照组(96.23%VS 81.82%),均P<0.05。干预组AIS患者的医生和护士的医院感染防控及气道管理知识考核得分、手卫生依从率均高于对照组(均P<0.001)。结论运用院前院内一体化管理模式对AIS患者进行早期干预,可降低患者误吸及坠积性肺炎发生率,有效缩短患者住院时间,提升患者满意度,同时还能增强医务人员感染防控意识,提高医院感染防控水平,值得在临床上推广应用。

Objective To explore the effect of integrated pre-and in-hospital management on reducing the incidence of aspiration and hypostatic pneumonia in patients with acute ischemic stroke(AIS). Methods 108 AIS patients who were diagnosed and treated in a hospital from March 2020 to October 2021 were selected as the research objects, according to the different intervention time and management modes, 55 AIS patients who received routine nursing operation in the hospital from March to December 2020 were as control group, and 53 AIS patients who received integrated pre-and in-hospital management from January to October 2021 were as intervention group, incidence of aspiration and hypostatic pneumonia, average hospitalization time, patient satisfaction of two groups of AIS patients, as well as scores in the examination of infection prevention and control, airway management knowledge, compliance rate of hand hygiene of doctors and nurses in two patients’ groups were compared. Results Incidences of aspiration and hypostatic pneumonia in AIS patients in intervention group were 9.43% and 3.77% respectively, which were both lower than those in control group(25.45% and 14.55% respectively);the average hospitalization time of intervention group was shorter than that of control group([10.79±5.35] days vs([13.69±6.84] days), patients’ satisfaction was higher than that of control group(96.23% vs 81.82%)(all P< 0.05). The scores of knowledge on healthcare-associated infection(HAI) prevention and control, airway management as well as hand hygiene compliance rate of doctors and nurses in patients’ intervention group were higher than those in control group(all P<0.001). Conclusion Early intervention in AIS patients with integrated pre-and in-hospital management mode can reduce the incidence of aspiration and hypostatic pneumonia, effectively shorten hospitalization time of patients, improve the satisfaction of patients, enhance the awareness of infection prevention and control of health care workers, and improve prevention and control level of HAI, which is worthy of clinical promotion and application.