63所医院ICU护士对呼吸机管路更换频率的认知与行为现状调查

Nurses’cognition and behaviour on the replacement frequency of ventilator circuit in intensive care units in 63 hospitals

目的了解江苏省各级医院重症监护病房(ICU)护士对呼吸机管路的管理认知与行为,为规范临床医务人员管理呼吸机管路提供参考依据。方法运用自行设计调查问卷,采用便利抽样方法对ICU护士进行调查。结果最终回收问卷575份,有效回收率93.57%。共有来自13个城市63所医院538名ICU护士参与调查。共调查4种医院使用中的呼吸机管路类型,分别为一次性双加热呼吸管路(49所,77.78%)、一次性麻醉呼吸管路(46所,73.02%)、一次性单加热呼吸管路(34所,53.97%)和可重复消毒硅胶管路(22所,34.92%)。共调查12种医院使用中的呼吸机管路品牌,其中以Fisher&Paykel(28所,44.44%)最多,其次为Comen(18所,28.57%)。44.61%(240/538)的ICU护士表示除了在呼吸机管路有可见污染和出现故障时进行更换外,还会根据临床经验判断呼吸机管路是否需要更换;ICU护士认为间断停机(79.93%)、多重耐药菌感染(84.20%)和雾化吸入治疗(83.83%)会/可能会对呼吸管路使用时长产生影响;21.00%(113名)的ICU护士知晓其科室2021年呼吸机相关肺炎(VAP)发病率。结论临床使用的呼吸机管路类型和品牌较多,没有统一呼吸机管路更换频率,目前更换频率以7 d居多,建议根据医院或科室的护理流程和规范更换呼吸机管路。

Objective To understand nurses’cognition and behaviour on the management of ventilator circuit in intensive care units(ICUs)of hospitals at all levels in Jiangsu Province,and provide reference for standardizing health care workers’management on ventilator circuit.Methods Self-designed survey questionnaires and conve-nient sampling were adopted to investigate ICU nurses.Results 575 questionnaires were finally collected,with an effective response rate of 93.57%.538 ICU nurses from 63 hospitals in 13 cities participated in the survey.Four types of ventilator circuits used in hospitals were investigated,including disposable double heating ventilator circuit(49 hospitals,77.78%),disposable anaesthesia ventilator circuit(46 hospitals,73.02%),disposable single hea-ting ventilator circuit(34 hospitals,53.97%),and repeated disinfectant reusable silica gel circuit(22 hospitals,34.92%).A total of 12 brands of ventilator circuits used in hospitals were investigated,with Fisher&Paykel being the most popular(28 hospitals,44.44%),followed by Comen(18 hospitals,28.57%).Besides replacing ven-tilator circuit when there was visible contamination or circuit dysfunction,44.61%(240/538)ICU nurses would judge whether ventilator circuits need to be replaced based on their clinical experience.ICU nurses believed that intermittent turning off machine(79.93%),multidrug-resistant organism infection(84.20%),and inhalation therapy(83.83%)could/might impact the duration of ventilator circuit use.21.00%(n=113)ICU nurses were aware of the incidence of ventilator-associated pneumonia(VAP)in their departments in 2021.Conclusion Multiple types and brands of ventilator circuits are used clinically.There is no unified replacement frequency for ventilator circuit.Currently,common replacement frequency is every 7 days.It is recommended to replace ventilator circuit according to the nursing care process and the standards of hospital or department.