Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

The Effect of Personalized Comprehensive Care on the Nursing Care of Severe Pneumonia Patients

Objective:To explore the value of receiving personalized comprehensive care for patients with severe pneumonia.Methods:73 patients with severe pneumonia who visited the clinic from February 2020 to February 2023 were included in this study.The patients were randomly grouped into Group A and Group B.Group A received personalized comprehensive care whereas Group B received conventional care.The value of care was compared.Results:The duration of mechanical ventilation time,the time taken for fever and dyspnea relief,and the hospitalization time of Group A were shorter than those in Group B(P<0.05).The blood gas indexes such as PaO_(2),PaCO_(2),and blood pH of Group A were better than those of Group B(P<0.05).The pulmonary function indexes such as peak expiratory flow(PEF),forced vital capacity(FVC),and forced expiratory volume in 1 second(FEV_(1))of Group A were better than those of Group B,P<0.05.Moreover,the patients in Group A were generally more satisfied with the care given compared to the patients in Group B(P<0.05).Conclusion:Personalized comprehensive care improves blood gas indexes,enhances lung function,accelerates the relief of symptoms,and also enhances patient satisfaction in severe pneumonia patients.

Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain:Prevalence and antibiotics susceptibility pattern

BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients.VAP incidence showed wide variability between countries.AIM To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.METHODS The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020.It included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical ventilation.VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic evidence.RESULTS The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155.Forty-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±20.Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±6.55.Gram-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified pathogen.CONCLUSION The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.

Risk factors for ventilator-associated pneumonia in trauma patients:A descriptive analysis

BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia(VAP)and whether the location of intubation posed a risk in trauma patients.METHODS:Data were retrospectively reviewed for adult trauma patients requiring intubation for>48 hours,admitted between 2010 and 2013.Patients’demographics,clinical presentations and outcomes were compared according to intubation location(prehospital intubation[PHI]vs.trauma room[TRI])and presence vs.absence of VAP.Multivariate regression analysis was performed to identify predictors of VAP.RESULTS:Of 471 intubated patients,332 patients met the inclusion criteria(124 had PHI and208 had TRI)with a mean age of 30.7±14.8 years.PHI group had lower GCS(P=0.001),respiratory rate(P=0.001),and higher frequency of head(P=0.02)and chest injuries(P=0.04).The rate of VAP in PHI group was comparable to the TRI group(P=0.60).Patients who developed VAP were 6 years older,had significantly lower GCS and higher ISS,head AIS,and higher rates of polytrauma.The overall mortality was 7.5%,and was not associated with intubation location or pneumonia rates.In the early-VAP group,gram-positive pathogens were more common,while gram-negative microorganisms were more frequently encountered in the late VAP group.Logistic regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the models.CONCLUSION:In trauma,the risk of developing VAP is multifactorial.However,the location of intubation and presence of chest injury could play an important role.

Distribution and antibiotic resistance of pathogens isolated from ventilator-associated pneumonia patients in pediatric intensive care unit

BACKGROUND： With mechanical ventilation widely used in intensive care unit, the ventilator associated pneumonia （VAP） has become a common and serious complication in critically ill patients. Compared with adults, the incidence of VAP and the mortality are higher in children in pediatric intensive care unit （PICU） because of immune deficiency, severe basic diseases, and increased use of artificial airway or mechanical ventilation. Hence it is of significance to study the epidemiology and changes of antibacterial susceptibility in order to reduce the incidence and mortality of VAP in children.METHODS： From January 2008 to June 2010, 2758 children were treated in PICU of Wuhan Children＇s Hospital. Among them, 171 received mechanical ventilation over 48 hours in PICU, and 46 developed VAP. The distribution and drug-resistance pattern of the pathogenic bacteria isolated from lower respiratory tract aspirations were analyzed. RESULTS：A total of 119 pathogenic microbial strains were isolated. Gram-negative bacilli （G-） were the most （65.55%）, followed by fungi （21.01%） and gram-positive cocci （G~, 13.45%）. Among them, the most common pathogens were Acinetobacter baummannii, Escherichia coli, Klebsiella pneumoniae, candida albicans and coagulase-negative staphylococci. Antibiotic susceptibility tests indicated that the multiple drug-resistances of G- and G＋to antibiotics were serious. Most of G- was sensitive to ciprofloxacin, amikacin, imipenem, meropenem, cefoperazone-sulbactam and piperacillin-tazobactam. The susceptibility of G＋ to vancomycin, teicoplanin and linezolid were 100%. Fungi were almost sensitive to all the antifungal agents. The primary pathogens of VAP were G-, and their multiple drug-resistances were serious. CONCLUSION： In clinical practice we should choose the most sensitive drug for VAP according to pathogenic test.

Effect of traditional Chinese preparation Xuebijing on inflammatory markers in patients with ventilator-associated pneumonia

Objective:To observe the effect of Xuebijing,a complex traditional Chinese preparation,on inflammation and prognosis of patients with pneumonia.Methods:The patients with ventilator-associated pneumonia in the intensive care unit(ICU)were randomly divided into the control group and the treatment group with 35 cases in each group.Both groups were given routine treatment such as anti-inflammatory drugs,rehydration,expectorant,and nutritional support,while the treatment group was additionally given Xuebijing injection.Serum C-reactive protein(CRP),clinical pulmonary infection score(CPIS),acute physiology,and chronic health scoreⅡ(APACHEⅡ)were recorded before treatment,the 3rd and 7th day after treatment.The duration of antibiotic use,mechanical ventilation,ICU stay,and mortality during 28 days was recorded.Results:There was no significant difference in CRP,CPIS,and APACHEⅡbetween the two groups before treatment(P>0.05).The improvement of CRP,CPIS,and APACHEⅡin the treatment group was better than those in the control group on the 3 and 7 days after treatment,and the differences were statistically significant(P<0.05).The duration of antibiotic use,mechanical ventilation,and ICU stay in the treatment group were less than those in the control group(P<0.05).The 28-day mortality of the treatment group was lower than that of the control group,but the difference was not statistically significant(P>0.05).Conclusions:Xuebijing injection can improve the inflammatory indexes of patients with ventilator-associated pneumonia,and can partly improve the prognosis.

Application of the Modality of Multiple Disciplinary Team for a Perioperative Patient with Suspected Novel Coronavirus Pneumonia and Cervical Spine Fracture in Nursing

With the explosive spread of novel coronavirus pneumonia, a major public major public health emergency has been declared around the world. Our country has come to a crucial stage of “external defense input, internal defense rebound” and strict quarantine measures are taken in all ports of entry throughout the country. Operations on patients with cervical spine during the quarantine, which not only increases the risk of surgical treatment, but also increases the difficulty of perioperative nursing. The objective is to explore the result of application of the modality of multiple disciplinary team for a perioperative patient with suspected novel coronavirus pneumonia and cervical spine fracture in nursing. The patient’s condition and nursing measures are studied and discussed from various specialist angle through the multidisciplinary team established by the isolation ward, orthopedics department, emergency department, anesthesiology department, operating room, rehabilitation department, psychology department and so on, and the overall and personalized surgical and nursing planning is formed through interdisciplinary advice. The nursing experience is summarized in this paper.

Ventilator-associated pneumonia in patients with cancer: Impact of multidrug resistant bacteria

BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,creating a new burden on medical care in hospitals,particularly for patients admitted to the intensive care unit(ICU).AIM To describe risk factors for ventilator-acquired pneumonia(VAP)in patients with cancer and to evaluate the impact of MDRB.METHODS A retrospective study was performed from January 2016 to December 2018 at a cancer referral center in Mexico City,which included all patients who were admitted to the ICU and required MV≥48 h.They were classified as those who developed VAP versus those who did not;pathogens isolated,including MDRB.Clinical evolution at 60-d was assessed.Descriptive analysis was carried out;comparison was performed between VAP vs non-VAP and MDRB vs non-MDRB.RESULTS Two hundred sixty-three patients were included in the study;mean age was 51.9 years;52.1%were male;68.4%had solid tumors.There were 32 episodes of VAP with a rate of 12.2%;11.5 episodes/1000 ventilation-days.The most frequent bacteria isolated were the following:Klebsiella spp.[n=9,four were Extended-Spectrum Beta-Lactamase(ESBL)producers,one was Carbapenem-resistant(CR)];Escherichia coli(n=5,one was ESBL),and Pseudomonas aeruginosa(n=8,two were CR).One Methicillin-susceptible Staphylococcus aureus was identified.In multivariate analysis,the sole risk factor associated for VAP was length of ICU stay(OR=1.1;95%CI:1.03-1.17;P=0.003).Sixty-day mortality was 53%in VAP and 43%without VAP(P=0.342).There was not higher mortality in those patients with MDRB.CONCLUSION This study highlights the high percentage of Gram-negative bacteria,which allows the initiation of empiric antibiotic coverage for these pathogens.In this retrospective,single center,observational study,MDRB VAP was not directly linked to increased mortality at 60 days.

Respiratory mechanics,ventilator-associated pneumonia and outcomes in intensive care unit

AIM To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit(ICU) of a hospital in southern Brazil. METHODS A cohort study was conducted between, involving a sample of 120 individuals. Static measurements of compliance and resistance of the respiratory system in pressure-controlled ventilation (PCV) and volumecontrolled ventilation(VCV) modes in the 1 st and 5 th days of hospitalization were performed to monitor respiratory mechanics. The severity of the patients' illness was quantified by the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ). The diagnosis of VAP was made based on clinical, radiological and laboratory parameters.RESULTS The significant associations found for the development of VAP were APACHE Ⅱ scores above the average(P = 0.016), duration of MV (P = 0.001) and ICU length of stay above the average(P = 0.003), male gender(P = 0.004), and worsening of respiratory resistance in PCV mode(P = 0.010). Age above the average(P < 0.001), low level of oxygenation on day 1(P = 0.003) and day 5 (P = 0.004) and low lung compliance during VCV on day 1 (P = 0.032) were associated with death as the outcome.CONCLUSION The worsening of airway resistance in PCV mode indicated the possibility of early diagnosis of VAP. Low lung compliance during VCV and low oxygenation index were death-related prognostic indicators.

Antimicrobial resistance pattern in ventilator-associated pneumonia in an intensive care unit of Babol, northern Iran

Objective:To investigate antibiotic resistance pattern of ventilator-assiated pneumonia (VAP) generating microorganisms,and quantitative culture and determining antibiotic sensitivity.Methods:This cross sectional study was performed on 50 patients suffering from VAP in intensive care unit of Ayatollah Rouhani Hospital,Babol,Iran during 2014-2015.VAP was probable for them based on clinical signs and the criteria of Clinical Pulmonary Infection Score standards.Lower respiratory samples were given under bronchoalveolar lavage and quantitative culture was done on them.Afterwards by microdilution method,minimal inhibitory concentration based on respective microorganisms,considering clinical pulmonary infection score were determined.Results:From 50 investigated samples in this study,the most common microorganisms were Acinetobacter baumannii (A.baumannii) (70%) then Pseudomonas aeruginosa (12%),Staphylococcus aureus (8%) and Klebsiella pneumonia (3%).In our study A.baummannii showed approximate 100% resistance to all antibiotics,in a way that A.baumannii resistance to imipenem and meropenem and piperacillin/tazobactam each was 97.1%.The most resistance of Pseudomonas aeruginosa was 66.7% to each cefepime and ceftazidime and clavulanate/ticarcillin.Staphylococcus aureus showed 75% resistance to nafcillin,cloxacillin and resistance in case of vancomycin was not seen.Conclusion:In current study,A.baumannii had the most prevalence among VAP and this species is resistant to most of antibiotics.Using ceftazidime,cefepime and clavulanate/ticarcillin,in treatment of the patients suffering VAP is not reasonable.

A Nursing Case Report: The Laryngectomy Patient Secondary to <i>Pseudomonas aeruginosa</i>Pneumonia with Conscious Disturbance

The paper presents a description of the experience of the nursing for the Pseudomonas aeruginosa pneumonia patient with partial laryngectomy. The nursing of Pseudomonas aeruginosa pneumonia, conscious disturbance, electrolyte disorder, affection supports and mental nursing was provided in the process of the postoperative treatment. Our experience may provide useful insight for the nursing of laryngectomy patients secondary to pneumonia with conscious disturbance. A deeper knowledge about improving the quality of clinic special nursing for the partial or total laryngectomy patient is necessary, with the development of modern medical technologies and medicine.

A Survey of Learning Needs about Oral Care for Intubated Patients among New Nursing Staff

Our aim was to understand the actual conditions of oral care for intubated patients by new nurses. This study was carried out from December 2017 to March 2018. We applied the theme of the dissipation of the dissociation between nursing skills learned in basic nursing education and nursing skills required in practice. A questionnaire survey was conducted at four facilities among new nursing staff who had acquired their nursing license in the past year. The questionnaire was composed of questions about their experiences of oral care for intubated patients, when they learned these skills, and what they wanted to learn. Answers were obtained from 118 new nurses. Learning about oral care was important for approximately 20% of the nurses, although it was not considered mandatory by all of the nurses. As infection control measures have revealed the acute needs of care for intubated patients, it is important for nursing students to learn about oral care and attitudes towards intubated patients, along with methods to make intubated patients more comfortable.

Natural History, Outcomes and Antibiotic Treatment for Ventilator-Associated Tracheobronchitis in Critical Ill Patients

We assessed incidence and outcomes of patients with ventilator-associated respiratory infections (VARI) due to tracheobronchitis (VAT) and pneumonia (VAP), including length of intensive care unit (ICU) stay and ventilator days. We also examined pathogens, rate of progression from VAT to VAP, and impact of antibiotic therapy for VAT. Data analysis included 234 patients, 100 patients (43%) had at least moderate (+++) bacterial growth in their semi-quantitative endotracheal aspirate (SQ-ETA) cultures. VAT and VAP were each diagnosed in 34 (15%) patients. Staphylococcus aureus was the most common pathogen isolated and had the highest rate of progression from VAT to VAP. Seven (21%) of the 34 patients were diagnosed with VAT that later progressed to VAP in averaged 3 days. Patients diagnosed with VAT had significantly more ventilator days (9 vs 6, p p < 0.001) and hospital days (22 vs 17, p < 0.001). No significant difference was observed in the clinical outcomes of the 25 VAT patients with timely, appropriate antibiotics compared to the 9 VAT patients who did not receive timely appropriate antibiotics. VAT was a risk factor for increased ventilator days, longer length of ICU and hospital stay. The time window from VAT to VAP allowed physicians to identify the pathogens and sensitivity profile needed to treat VAT with appropriate antibiotics. Data from well-designed studies were needed to assess the impact of early, appropriate antibiotic therapy for VAT, the choice of antibiotics, as well as the duration and route of administration.

基于循证证据的脑卒中相关性肺炎预防措施在ICU急性缺血性脑卒中病人中的应用效果

目的:总结预防脑卒中相关性肺炎的循证证据并评价其临床应用效果。方法:选择2022年1月—12月安徽省某三级甲等医院神经内科ICU收治的59例急性缺血性脑卒中病人为研究对象,将2022年1月—5月收治的29例重症脑卒中病人为基线组,2022年8月—12月收治的30例重症脑卒中病人为循证实践组。以基于证据的持续质量改进模型作为理论框架,通过证据获取、现状审查、证据引入和效果评价4个阶段将脑卒中相关性肺炎预防的证据转化为临床实践。比较循证实践前后两组脑卒中病人脑卒中相关性肺炎的发生率、炎症指标和临床结局指标,以及循证实践前后医护人员预防脑卒中相关性肺炎证据认知水平变化。结果:最终纳入18条证据,并转化为10条审查指标。循证实践后,病人脑卒中相关性肺炎发生率及白细胞计数、C反应蛋白、ICU住院时间均明显降低(P<0.05)。循证实践后医护人员预防脑卒中相关性肺炎知识审查指标执行率均提高(P<0.05)。结论:以证据为基础的循证护理实践能够提高医护人员循证知识知晓率及对最佳证据的依从性,改善脑卒中病人的炎症指标,缩短ICU住院时间,降低脑卒中病人脑卒中相关性肺炎的发生率。

针对性气道护理对重症监护室患者舒适度与呼吸机相关性肺炎的影响

目的探讨针对性气道护理模式在重症监护室(ICU)患者中的应用效果。方法选择2021年1月—2022年12月医院120例ICU患者,按组间基线资料可比的原则将其分为对照组和观察组,每组60例。对照组予以常规护理,观察组采用针对性气道护理。观察两组患者护理干预前、护理干预5 d后的呼吸状况及舒适度,比较其康复进程、导管堵塞情况及呼吸机相关性肺炎(VAP)发生情况。结果观察组患者护理干预5 d后的PaO_(2)水平高于对照组,组间比较差异有统计学意义(P<0.05)。PaCO_(2)水平低于对照组,组间比较差异有统计学意义(P<0.05)。观察组患者护理干预5 d后的Kolcaba舒适状况量表(GCQ)评分高于对照组,差异有统计学意义(P<0.05)。观察组患者机械通气时间及ICU治疗时间分别为6.50±1.08 d和7.84±1.50 d,短于对照组的7.22±1.36 d和8.68±1.74 d,差异有统计学意义(P<0.05);观察组患者机械通气期间的导管堵塞程度较对照组轻,且VAP发生率低于对照组,差异均有统计学意义(P<0.05)。结论针对性气道护理模式可改善ICU患者呼吸状况及舒适度,缩短康复进程,并可减轻患者机械通气治疗期间导管堵塞程度,降低VAP发生率。

无痛经食管超声心动图检查后并发症发生现状及影响因素

目的:调查无痛经食管超声心动图(TEE)检查后并发症发生现状,并分析其影响因素。方法:选取2021年12月—2023年5月在北京大学第三医院行无痛TEE检查的396例住院病人为研究对象。对其一般资料及无痛TEE检查后并发症发生情况进行调查。结果:396例病人中,发生检查相关并发症的病人为51例,占12.9%。Logistic回归分析结果显示,年龄、检查体位是无痛TEE检查后并发症发生的影响因素(P<0.05)。结论:无痛TEE检查后并发症发生率较低,左侧卧位检查可进一步减少吸入性肺炎发生,高龄病人需给予更多的护理措施以减少并发症发生。

兴趣诱导结合个性化护理在肺炎患儿治疗中的应用效果

目的:探讨兴趣诱导结合个性化护理在肺炎患儿治疗中的应用效果.方法:选取2022年2月至2023年2月本院收治的104例肺炎患儿作为研究对象.按随机数字表法,将其分为研究组(n=52,采用兴趣诱导结合个性化护理模式)和对照组(n=52,采用常规护理).比较两组患儿相关症状消失时间,护理前、后肺功能指标及护理依从性.结果:研究组患儿发热、咳嗽、呼吸急促、肺部啰音等症状消失时间均短于对照组,差异有统计学意义(P<0.05);两组患儿护理后与护理前相比,肺功能指标[用力肺活量(FVC)、第1秒用力呼气量(FEV1)、第1秒用力呼气量占全部呼气量比值(FEV1/FVC)]均有改善,并且研究组改善水平高于对照组,差异均有统计学意义(P<0.05);研究组患儿总依从率(92.31%,48/52)显著高于对照组(65.38%,34/52),差异有统计学意义(P<0.05).结论:兴趣诱导结合个性化护理在肺炎患儿治疗中能加快缓解患儿临床症状,改善肺功能,提升患儿对护理工作的依从性,建立良好医患关系,值得临床推广应用.

床旁超声探查气管插管患者声门下分泌物及其滞留的危险因素分析

目的应用床旁超声探查气管插管患者声门下分泌物,并分析其滞留的危险因素。方法选取2023年1月-6月在综合ICU接受治疗的200例气管插管患者,通过床旁超声技术判断是否发生气管插管声门下分泌物滞留,分为滞留组与无滞留组。采用单因素分析气管插管患者声门下分泌物滞留的影响因素,并使用二元Logistic回归分析气管插管患者声门下分泌物滞留的高危因素。结果200例气管插管患者中声门下分泌物滞留的患者106例,占比53%。单因素分析显示,年龄、插管天数、插管材质、声门下吸引气管插管比例、留置胃管、8 mm气管插管、非全麻手术患者疾病种类比例是声门下分泌物滞留的影响因素。二元Logistic回归分析显示,年龄(OR=0.699)和留置胃管(OR=2.499)是声门下分泌物滞留的独立危险因素(P<0.05)。结论床旁超声在气管插管患者声门下分泌物探查中具有一定的应用价值,年龄和留置胃管是声门下分泌物滞留的独立危险因素,为临床护理人员加强气道管理提供了理论参考。

专项护理干预在重症肺炎合并呼吸衰竭患者中的应用效果

目的探讨专项护理干预在重症肺炎合并呼吸衰竭患者中的应用效果。方法选取2020年2月—2022年11月首都医科大学附属北京潞河医院收治的75例重症肺炎合并呼吸衰竭患者为研究对象,根据护理干预方法不同分为观察组(n=39)和对照组(n=36)。对照组采用常规护理干预,观察组患者在对照组基础上采用专项护理干预。比较2组患者干预前后汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)量表评分、世界卫生组织生存质量测定简表(WHOQOL-BREF)评分及干预期间并发症发生情况。结果2组患者干预前HAMA及HAMD评分比较,差异均无统计学意义(P>0.05);2组患者干预后HAMA及HAMD评分均低于干预前,且观察组患者均低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前PSQI量表7个维度评分及总分比较,差异均无统计学意义(P>0.05);2组患者干预后PSQI量表的睡眠持续时间、睡眠效率、入睡所需时间、睡眠质量、促睡眠药物、睡眠障碍、日间功能障碍7个维度评分及总分均低于干预前,且观察组患者均低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前WHOQOL-BREF量表各维度评分比较,差异均无统计学意义(P>0.05);2组患者干预后WHOQOL-BREF量表的生理功能、心理状态、躯体健康、社会功能4个维度评分均高于干预前,且观察组患者均高于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为7.69%(3/39),低于对照组的27.78%(10/36),差异有统计学意义(χ^(2)=5.271,P=0.022)。结论将专项护理干预应用于重症肺炎合并呼吸衰竭患者的护理中,能有效改善患者的心理状况及睡眠质量,提高患者生活质量,降低并发症的发生风险。

个性化早期综合肺康复护理在老年重症社区获得性肺炎机械通气患者中的应用

目的探索个性化早期综合肺康复护理在老年重症社区获得性肺炎(SCAP)行机械通气治疗患者中的应用效果。方法选取医院收治100例老年重症社区获得性肺炎行机械通气患者为研究对象,随机分为对照组50例和试验组50例。对照组实施常规综合护理干预,试验组在对照组基础上实施个性化早期综合肺康复护理。比较两组干预后的呼吸生理指标(肺氧合功能、乳酸、浅快呼吸指数)、炎症相关指标、机械通气时间、首次脱机成功率、ICU治疗时间、机械通气并发症(肺不张发生率、肢体血栓发生率)。结果干预后,试验组氧合指数值高于对照组(P<0.05),浅快呼吸指数、血清乳酸值、白细胞计数、降钙素原、C反应蛋白水平低于对照组(P<0.05)。试验组的首次脱机成功率高于对照组(P<0.05),机械通气时间、ICU治疗时间、肺不张发生率、肢体血栓发生率及并发症总发生率低于对照组(P<0.05)。结论个性化早期肺综合康复护理能够有效改善老年SCAP机械通气患者的肺氧合功能,减轻炎症反应,降低并发症发生率,促进患者康复。