集束化护理在机械通气患者行高压氧治疗中的应用

Application of bundled nursing care on patients under mechanical ventilation during hyperbaric oxygen therapy

目的探讨集束化护理在机械通气患者行高压氧治疗中的应用效果。方法选取2019年1月至2021年12月在海军第九七一医院军事医学与特种学科治疗的50例机械通气患者作为研究对象,按随机数字表法分为观察组和对照组,每组25例。对照组给予常规护理;观察组在对照组的基础上由ICU舱集束化护理小组给予舱内综合护理。高压氧治疗2个疗程后,统计观察组集束化护理各项措施的执行率,比较2组患者的误吸、呼吸机相关性肺炎(VAP)发生率,脱机时间和家属满意度。结果开展培训明确职责、体位管理、饮食管理的执行率为100%,口腔护理、吸痰护理、气囊压管理、气道湿化、预防非计划性拔管的执行率为96%,无菌操作及消毒隔离的执行率为92%。观察组患者误吸、VAP发生率(4%、4%)明显低于对照组(16%、20%),差异有统计学意义(P<0.01)。观察组患者脱机时间为(8.16±2.67)d,比对照组的(13.26±3.93)d明显减少,差异有统计学意义(P<0.01)。2组患者家属满意度比较差异无统计学意义(P>0.05)。结论对舱内机械通气患者采用集束化护理能够规范操作流程,优化护理措施,减少并发症的发生。

Objective To explore the effects of bundled nursing care on patients under mechanical ventilation during hyperbaric oxygen therapy(HBOT).Methods A total of 50 patients under mechanical ventilation in the Department of Military Medicine and Special Disciplines of the No.971 PLA Navy Hospital from January 2019 to December 2021 were selected as the research subjects and divided into observation group and control group according to the random number table method,with 25 cases in each group.The control group was given conventional symptomatic nursing care,while the observation group was given comprehensive nursing care provided by the ICU bundled nursing care team based on those in the control group.After two courses of HBOT,the execution rates of bundled nursing care measures in the observation group were statistically observed;and the incidence of aspiration,ventilator-associated pneumonia(VAP),weaning time of patients,and the family satisfaction were compared between the two groups.Results The executive rates of conducting trainings to clarify responsibilities,carrying out body position management,and dietary management were all 100%.The execution rates of oral care,sputum suction care,bag pressure management,airway humidification,and prevention of unplanned extubation were 96%,while those of aseptic operation and disinfection isolation were 92%.The incidence of aspiration and VAP in the observation group(4%and 4%)were significantly lower than those(16%and 20%)in the control group,respectively(P<0.05).The weaning time of the observation group was significantly reduced compared with the control group,with statistically significant difference[(8.16±2.67)d vs.(13.26±3.93)d,P<0.05].There was no statistically significant difference in family satisfaction between the two groups(P>0.05).Conclusion The application of bundled nursing care in patients under mechanical ventilation in hyperbaric oxygen chamber can standardize the operating process,optimize nursing care measures,and reduce the incidence of complications.