Bagheri-Nesami Masoumeh, Amiri-Abchuyeh Maryam, Gholipour-Baradari Afshin, Yazdani-Cherati Jamshid, Nikkhah Attieh
Faculty, Department of Medical Surgical Nursing, Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences , Sari, Iran .
Critical Care Nurse, Nasibeh Nursing and Midwifery School, Mazandaran University of Medical Sciences , Sari, Iran .
J Clin Diagn Res. 2015 Aug;9(8):IC05-IC08. doi: 10.7860/JCDR/2015/11996.6308. Epub 2015 Aug 1.
The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP.
The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran.
This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability.
The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all.
The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.
预防呼吸机相关性肺炎指南的实施已被证明在降低VAP发病率方面有显著效果。
本研究的目的是评估伊朗萨里市大学医院重症监护病房(ICU)中VAP预防策略的实施情况。
这项横断面研究于2012年4月至6月在萨里市大学医院的ICU中以600床日进行。采用便利抽样技术对ICU中接受机械通气的患者进行抽样。通过具有先前认可的有效性和可靠性的标准检查表评估预防措施的实施情况。
各项措施的实施百分比分别如下:无菌吸痰,88.44%;半卧位,76.8%;口腔卫生,58.45%;使用热湿交换器(HMEs),58%;控制气囊压力,46.8%;手部卫生,32.8%;使用抗凝剂,26.8%;物理治疗,25.5%。完全未使用密闭吸痰系统、声门下分泌物持续引流和动力床。
预防措施的总体平均实施百分比很低,需要根据每个国家ICU的情况制定综合指南,并对工作人员进行教育和鼓励,使其使用推荐的指南。