耐甲氧西林金黄色葡萄球菌呼吸机相关性肺炎预防方案的应用

Application of the prevention programme for methicillin resistant staphylococcus aureus ventilator associated pneumonia

目的验证耐甲氧西林金黄色葡萄球菌呼吸机相关性肺炎(MRSA-VAP)预防方案的有效性和可行性。方法按照住院先后顺序将综合ICU 62例患者分为对照组和观察组各31例。对照组实施ICU常规护理,观察组以渥太华证据转化模式为理论框架,在以往研究基础上制订并实施MRSA-VAP预防方案。结果培训后,医护人员MRSA-VAP预防知识水平显著高于干预前(P<0.01)。干预后,观察组发生MRSA定植2例(6.45%),经去定植处理后MRSA定植0例;观察组MRSA-VAP发生率、机械通气时间、ICU住院费用显著低于对照组(P<0.05,P<0.01)。结论应用MRSA-VAP预防方案有利于提高医护人员MRSA-VAP预防知识水平,降低ICU患者MRSA-VAP发生率,缩短机械通气时间和降低ICU住院费用。

Objective To verify the effectiveness and feasibility of the prevention programme for methicillin resistant staphylococcus aureus ventilator associated pneumonia(MRSA-VAP).Methods Totally 62 patients in ICU were divided into a control group and an observation group chronologically,with 31 patients in each group.The control group was given routine ICU nursing,while the observation group was taken Ottawa evidence transformation mode as theoretical framework,the MRSA-VAP prevention programme was formulated and applied in clinical practice based on previous study.Results After the training,medical staff’s knowledge on MRSA-VAP prevention was significantly higher than that before the training(P<0.05).After the intervention,2 patients(6.45%)in the observation group encountered MRSA colonization,which decreased to 0 after decolonization.The incidence of MRSA-VAP,the time of mechanical ventilation and costs in ICU of the observation group were significantly lower than those of the control group(P<0.05,P<0.01).Conclusion Application of the MRSA-VAP prevention programme is conducive to improving medical staff′s knowledge on MRSA-VAP prevention,decreasing ICU patients′incidence of MRSA-VAP,shortening the time of mechanical ventilation and reducing ICU costs.