Sachetti Amanda, Rech Viviane, Dias Alexandre Simões, Fontana Caroline, Barbosa Gilberto da Luz, Schlichting Dionara
Faculdade de Fisioterapia, Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Rev Bras Ter Intensiva. 2014 Oct-Dec;26(4):355-9. doi: 10.5935/0103-507X.20140054.
To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilator-associated pneumonia.
A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia.
Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389).
The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.
评估重症监护病房对呼吸机护理集束化方案的依从性，并确定依从性对呼吸机相关性肺炎发生率的影响。
使用包含以下项目的检查表，对198张床位进行了60天的评估：床头抬高至30至45度；加湿器过滤器位置；呼吸机回路中无积水；口腔卫生；气囊压力；以及物理治疗。接下来，开展了一次教育讲座，并在随后的60天内对235张床位进行了评估。还收集了呼吸机相关性肺炎的发生率数据。
对以下呼吸机护理集束化方案项目的依从性有所提高：床头抬高从18.7%提高到34.5%；呼吸机回路中无积水从55.6%提高到72.8%；口腔卫生从48.5%提高到77.8%；气囊压力从29.8%提高到51.5%。干预前后呼吸机相关性肺炎的发生率在统计学上相似（p = 0.389）。
本研究中进行的教育干预提高了对呼吸机护理集束化方案的依从性，但在评估的小样本中，呼吸机相关性肺炎的发生率并未降低。
