實施臨床指引對預防呼吸機相關性肺炎的經驗分享

Implementation of clinical guidelines for the prevention of ventilator-associated pneumonia:an experience sharing

目的提升呼吸機通氣病人床頭抬高和氣管插管或氣管切開套管氣囊壓力監測的依從性。方法對護士、護士助理、病室服務員進行理論培訓;每次科會進行總結、提醒;每天進行監督等措施。結果呼吸機通氣病人床頭抬高≧30o依從性合格率由31.2%提升至57.93%,氣管插管或氣管切開套管氣囊監測合格率由28.22%提升至68.45%,V A P發生率由8.5‰下降至7.85‰。結論每日監測預防VAP措施的執行情況能提高依從性的合格率,使VAP的發生率有所下降。

Objective To promote the compliance of head of bed elevation and endotracheal or tracheostomy tube cuff pressure monitoring in mechanical ventilation patients.Methods Provision of related theories training for nurses,nurse assistants,and ward attendants;supervision of related measures implementation;and summarizing and reminding of the implementation of measures in the department meeting.Results The compliance of head of bed elevation≥30o in mechanical ventilation patients increased from 31.2%to 57.93%,the compliance of cuff pressure monitoring increased from 28.22%to 68.45%,and the VAP morbidity decreased from 8.5‰to 7.85‰.Conclusion The compliance improved when VAP prevention measures implementation were daily supervised,thereby the VAP morbidity decreased.