Crimlisk Janet T, Gustafson Kristin A, Silva Julie
Nursing Division, Acute Rehabilitation Center, Boston Medical Center, Massachusetts 02118, USA.
Dimens Crit Care Nurs. 2012 Mar-Apr;31(2):118-23. doi: 10.1097/DCC.0b013e3182446022.
Ventilator-associated pneumonia has significant mortality (33%-50%). The highest risk of ventilator-associated pneumonia is early in mechanical ventilation with an increase in morbidity and mortality seen with late-onset ventilator-associated pneumonia. Prevention strategies have been recommended for acute care facilities, but there is lack of evidence-based data and recommendations for acute rehabilitation units. A multidisciplinary team designed an evidence-based ventilator-associated pneumonia prevention policy based on the Institute for Healthcare Improvement ventilator bundle. Education of rehabilitation staff and implementation of the protocol were done. Results showed that the ventilator-associated pneumonia rate decreased from 7.5 to 0 per 1000 patient ventilator days. Translating evidence-based guidelines into practice can be accomplished using a multidisciplinary team.
呼吸机相关性肺炎具有较高的死亡率(33%-50%)。呼吸机相关性肺炎的最高风险出现在机械通气早期,而迟发性呼吸机相关性肺炎的发病率和死亡率会增加。已为急性护理机构推荐了预防策略,但缺乏针对急性康复单元的循证数据和建议。一个多学科团队基于医疗改进研究所的呼吸机集束方案制定了一项循证的呼吸机相关性肺炎预防政策。对康复 staff 进行了教育并实施了该方案。结果显示,呼吸机相关性肺炎的发生率从每1000例患者呼吸机日7.5例降至0例。使用多学科团队可以将循证指南转化为实践。