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多重耐药鲍曼不动杆菌肺部感染——重症监护病房中一个未被普遍认识的常见问题:一项现况研究

MDRPU -an uncommonly recognized common problem in ICU: A point prevalence study.

作者信息

Mehta Chitra, Ali MdTariq, Mehta Yatin, George Joby V, Singh Manish Kumar

机构信息

Institute of Critical Care and Anesthesia, Medanta the Medicity, Gurgaon, Haryana, 122001, India.

Institute of Critical Care and Anesthesia, Medanta the Medicity, Gurgaon, Haryana, 122001, India.

出版信息

J Tissue Viability. 2019 Feb;28(1):35-39. doi: 10.1016/j.jtv.2018.12.002. Epub 2018 Dec 31.

Abstract

BACKGROUND

Pressure ulcers (PU) usually occur over bony prominences in hospitalized patients. But they may occur due to medical devices referred also as Medical device related pressure ulcers (MDRPU). The United States National advisory panel (NPUAP) recognizes it as an important entity. MDRPU is one of the key quality indicators of hospital care, so far no data is available on MDRPU from the Indian Sub-continent.

AIM

The primary objective of the study was to examine prevalence and Risk factors of MDRPU in critically sick patients.

DESIGN

A Cross-sectional point prevalence study.

METHODS

All patients above 18 years of age admitted in Intensive care units (ICU) on the date of the survey were included in the study. It was conducted in medical, cardiothoracic and neurosurgical ICUs. Demographic and MDRPU data were recorded. MDRPU was staged as per National Pressure ulcer advisory panel staging system. Ethics Committee approval was obtained prior to the start of the study.

RESULTS

One hundred and forty-six patients were included. The prevalence of PU was 26.0%. The prevalence of MDRPU was found to be 19.2%. MDRPUs most commonly occurred with non-invasive ventilation mask (NIV) and nasogastric tube (NGT) (20% and 12.3% respectively). MDRPUs were associated with a longer ICU Stay.

CONCLUSIONS

MDRPUs pose a significant burden on healthcare. Our study showed significant prevalence rate of MDRPU which is comparable to those seen internationally. There is a compelling need to have continuous audits and structured training programs among healthcare professionals to prevent MDRPUs in critically sick patients.

摘要

背景

压疮(PU)通常发生在住院患者的骨隆突处。但也可能因医疗设备而发生,这类压疮也被称为与医疗设备相关的压疮(MDRPU)。美国国家咨询小组(NPUAP)将其视为一个重要问题。MDRPU是医院护理的关键质量指标之一,目前印度次大陆尚无关于MDRPU的相关数据。

目的

本研究的主要目的是调查危重症患者中MDRPU的患病率及危险因素。

设计

一项横断面现患率研究。

方法

纳入调查当日入住重症监护病房(ICU)的所有18岁以上患者。研究在医学、心胸外科和神经外科ICU进行。记录人口统计学和MDRPU数据。根据国家压疮咨询小组分期系统对MDRPU进行分期。研究开始前获得了伦理委员会的批准。

结果

共纳入146例患者。PU的患病率为26.0%。MDRPU的患病率为19.2%。MDRPU最常发生于无创通气面罩(NIV)和鼻胃管(NGT)(分别为20%和12.3%)。MDRPU与ICU住院时间延长有关。

结论

MDRPU给医疗保健带来了重大负担。我们的研究显示MDRPU的患病率较高,与国际上的情况相当。迫切需要对医护人员进行持续审计和开展结构化培训项目,以预防危重症患者发生MDRPU。

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