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呼吸机相关性肺炎的预防:采用集束化护理方法。

Prevention of ventilator-associated pneumonia: Use of the care bundle approach.

作者信息

Okgün Alcan Aliye, Demir Korkmaz Fatma, Uyar Mehmet

机构信息

Faculty of Nursing, Ege University, Izmir, Turkey.

Faculty of Nursing, Ege University, Izmir, Turkey.

出版信息

Am J Infect Control. 2016 Oct 1;44(10):e173-e176. doi: 10.1016/j.ajic.2016.04.237. Epub 2016 Jul 4.

Abstract

BACKGROUND

The ventilator-associated pneumonia (VAP) care bundle consists of evidence-based practices to improve the outcomes of patients receiving mechanical ventilatory therapy. This study aimed to investigate the implementation of the care bundle on VAP rates in this quasiexperimental study.

METHODS

The protocol of this study consisted of 3 phases. In the initial phase, observations were made to determine the VAP care bundle adherence of intensive care unit (ICU) nurses. In the second phase, education was provided to ICU nurses on the subject of the VAP care bundle. For the third phase, the effect of VAP care bundle adherence on the VAP rates after education was investigated.

RESULTS

The nurses' VAP care bundle adherence improved after education from 10.8% (n = 152) to 89.8% (n = 1,324) and showed statistically significant improvement (P = .0001 and P < .05). In this study, the VAP rates were determined as 15.91/10 ventilator-days before education and 8.50/10 ventilator days after education. It was found that the VAP rates after the education period were significantly lower than the VAP rates before education.

CONCLUSION

VAP care bundle implementation with education prepared according to evidence-based guidelines decreased VAP rates. Thus, implementation of the VAP care bundle on mechanically ventilated patients care is recommended.

摘要

背景

呼吸机相关性肺炎(VAP)护理集束方案包含基于证据的实践措施,以改善接受机械通气治疗患者的预后。本研究旨在通过这项准实验性研究,调查护理集束方案对VAP发生率的影响。

方法

本研究方案包括3个阶段。在初始阶段,进行观察以确定重症监护病房(ICU)护士对VAP护理集束方案的依从性。在第二阶段,就VAP护理集束方案的主题对ICU护士进行培训。在第三阶段,调查培训后VAP护理集束方案依从性对VAP发生率的影响。

结果

培训后护士对VAP护理集束方案的依从性从10.8%(n = 152)提高到89.8%(n = 1324),差异有统计学意义(P = 0.0001,P < 0.05)。在本研究中,培训前VAP发生率为每10个呼吸机日15.91例,培训后为每10个呼吸机日8.50例。发现培训期后的VAP发生率显著低于培训前。

结论

按照循证指南制定的培训方案实施VAP护理集束方案可降低VAP发生率。因此,建议对接受机械通气的患者实施VAP护理集束方案。

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