FOCUS-PDCA模式对ICU重症患者呼吸机相关性肺炎的影响

The Impact of FOCUS-PDCA Mode on Ventilator-Associated Pneumonia in Critically Ill Patients in ICU

目的分析发现-组织领导-明确情况-分析了解-改进方案(find organize clarify understand select,FOCUS)-计划-执行-检查-行动(plan do check act,PDCA)模式对重症监护室(intensive care unit,ICU)重症患者呼吸机相关性肺炎(ventilator associated pneumonia,VAP)的影响。方法选取2022年10月—2023年9月菏泽市牡丹人民医院ICU接受机械通气治疗的重症患者120例,根据干预时间将其分为2组,即2022年10月—2023年3月60例患者作为对照组,2023年4—9月60例患者作为研究组。对照组接受常规干预措施预防VAP,研究组在此基础上,采用FOCUS-PDCA模式预防VAP。比较2组患者机械通气时间、住院时间、住院费用、一次性脱机成功率与VAP发生率。结果与对照组相比,研究组机械通气时间、住院时间更短(P<0.05),住院费用更低(P<0.05)。研究组一次性脱机成功率为96.67%,高于对照组的85.00%(χ^(2)=4.904,P<0.05);VAP发生率为1.67%,低于对照组的13.33%(χ^(2)=4.324,P<0.05)。结论FOCUS-PDCA模式能够有效降低ICU重症患者VAP的发生率,缩短机械通气时间与住院时间,节省住院费用,提高一次性脱机成功率,具有临床应用价值。

Objective To analyze the impact of the discoveryorganizational leadership clarification situation analysis understanding improvement plan(FOCUS)plan execution check action(PDCA)model on ventilator associated pneumonia(VAP)in critically ill patients in the intensive care unit(ICU).Methods A total of 120 critically ill patients who received mechanical ventilation treatment in the ICU of Heze Mudan People's Hospital from October 2022 to September 2023 were selected,and were divided into two groups based on the intervention time,namely 60 patients from October 2022 to March 2023 as the control group,and 60 patients from April to September 2023 as the study group.The control group received routine intervention measures to prevent VAP,the study group on this basisused the FOCUSPDCA model to prevent VAP.The mechanical ventilation time,hospitalization time,hospitalization expenses,one-time offline success rate,and VAP incidence rate between two groups of patients were compared.Results Compared with the control group,the study group had shorter mechanical ventilation time and hospitalization time(P<0.05),and lower hospitalization costs(P<0.05).The one-time offline success rate of 96.67% in the study group was higher than 85.00%in the control group at(χ^(2)=4.904,P<0.05),and the VAP incidence rate was 1.67% lower than 13.33% inthe control group(χ^(2)=4.324,P<0.05).Conclusion The FOCUSPDCA model can effectively reduce the incidence of VAP in critically ill patients in ICU,shorten mechanical ventilation time and hospitalization time,save hospitalization costs,and improve the success rate of one-time offline use.It has clinical application value.