Dimens Crit Care Nurs. 2021;40(4):210-216. doi: 10.1097/DCC.0000000000000484.
Ventilator bundles have been reported to reduce the risk of ventilator-associated pneumonia. However, data concerning the role of the education of the intensive care unit (ICU) staff regarding the items in the bundle and the importance to adhere to its items on the development of ventilator-associated events (VAEs) are limited. This study aimed to compare the frequency of VAEs in subjects admitted to the ICU before and after the education of the ICU staff.
A total of 105 subjects were enrolled in this retrospective study. The ICU staff, including the physicians, respiratory therapists, and nurses, received a 2-day educational lecture regarding items in the bundle as well as the need to adhere to its items. The study population was divided into two according to the admission date: subjects who were admitted before the education of the ICU staff regarding the ventilator bundle (preeducation) and subjects who were admitted after the education of the ICU staff regarding the ventilator bundle (posteducation). The difference in VAE rate in subjects admitted before and after bundle training was the primary outcome measure of this study.
The bundle compliance rates presented by days were significantly higher in the posteducation group compared with the preeducation group. Moreover, the frequency of VAEs was significantly lower in posteducation subjects compared with preeducation subjects (4.7% vs 19.0%, P = .042). Ventilator-associated event rate was also lower in posteducation subjects compared with preeducation subjects (2.5/1000 vs 9.8/1000 ventilator days). There were no significant differences among the groups with respect to ICU mortality.
The educational intervention performed in this study not only increased the adherence to the ventilator care bundle but also led to a significant reduction in the rate of the VAEs in patients receiving mechanical ventilator support in the ICU.
据报道，呼吸机集束化干预措施可降低呼吸机相关性肺炎的发生风险。然而，关于 ICU 医护人员接受集束化干预措施中各项内容培训及其遵循每项内容对呼吸机相关性事件（VAE）发生的重要性的数据十分有限。本研究旨在比较 ICU 医护人员接受培训前后患者 VAE 的发生频率。
本回顾性研究共纳入 105 例患者。对 ICU 医护人员（包括医师、呼吸治疗师和护士）进行了为期 2 天的关于集束化干预措施中各项内容以及遵循其内容重要性的培训。根据患者入组日期将研究人群分为两组：入组前 ICU 医护人员接受过呼吸机集束化干预措施培训的患者（预培训组）和入组后 ICU 医护人员接受过呼吸机集束化干预措施培训的患者（后培训组）。本研究的主要观察指标为两组患者 VAE 发生率的差异。
后培训组患者的集束化干预措施依从率逐日升高，且显著高于预培训组。此外，与预培训组患者相比，后培训组患者的 VAE 发生率显著降低（4.7%比 19.0%，P=0.042）。后培训组患者的 VAE 发生率也显著低于预培训组（2.5/1000 机械通气日比 9.8/1000 机械通气日）。两组患者 ICU 死亡率无显著差异。
本研究中的教育干预不仅提高了呼吸机护理集束化干预措施的依从性，还显著降低了接受机械通气支持的 ICU 患者 VAE 的发生率。
