Department of Nursing, Shinsung University, 49, Duckmari, Jungmimyun, Dangjingun, Chungnam 343-861, Republic of Korea.
Intensive Crit Care Nurs. 2011 Aug;27(4):226-32. doi: 10.1016/j.iccn.2011.04.001. Epub 2011 Jun 15.
This study has analysed VAP prevention strategies and concentrating on approaches proven to have been effective by previous studies, has developed a general and systematic intervention for preventing VAP.
The VAP prevention program was composed of short-term interventions and long-term interventions. Using a time series design to verify the program's effectiveness, just before, just after, and 3 months after intervention, 27 convenient selected medical ICU nurses were surveyed for their awareness of VAP prevention and self-evaluation of VAP prevention performance as a subjective measure, and their VAP prevention performance was observed as an objective measure. The VAP incidence amongst ICU patients was measured during the 3 months before (n=80) and after (n=75) intervention.
That the program would raise nurses' VAP prevention awareness (p=.008) and would increase the nurses' subjective (p=.003) and objective (p≤.001) VAP prevention performance evaluations was supported. That incidences of VAP would decrease from a pre-intervention VAP rate of 17.382 (number of occurances/1000 ventilator days) to a post-intervention rate of 11.044, was not statistically significant (p=.074).
An intervention VAP prevention program promoted ICU nurses' VAP prevention awareness and performance and could therefore help decrease the VAP rate.
本研究分析了预防呼吸机相关性肺炎(VAP)的策略,并侧重于先前研究证明有效的方法,制定了一种预防 VAP 的通用且系统的干预措施。
VAP 预防方案由短期干预和长期干预组成。采用时间序列设计来验证方案的有效性,在干预前、干预后和干预后 3 个月,对 27 名随机选择的重症监护病房(ICU)护士进行了 VAP 预防意识调查和 VAP 预防表现的自我评估,作为主观测量,同时观察他们的 VAP 预防表现作为客观测量。在干预前(n=80)和干预后(n=75)的 3 个月期间,测量 ICU 患者的 VAP 发生率。
该方案将提高护士对 VAP 预防的认识(p=.008),并提高护士的主观(p=.003)和客观(p≤.001)VAP 预防表现评价,得到了支持。VAP 的发生率从干预前的 17.382(每 1000 个机械通气日发生次数)下降到干预后的 11.044,但无统计学意义(p=.074)。
一项预防 VAP 的干预方案提高了 ICU 护士的 VAP 预防意识和表现,因此有助于降低 VAP 发生率。