Harris R B, Hyman R B
Nurs Res. 1984 Mar-Apr;33(2):80-5.
As reported in the literature and observed in clinical practice, a variety of tracheotomy care procedures (tracheotomy suctioning and cleaning techniques) are currently used. The purpose of this research was to determine if clean tracheotomy care was more effective than sterile as measured by levels of postoperative pulmonary infection. Ten hospitals with large Head and Neck/ENT services were selected as data collection sites. At these centers a minimum of 15 tracheostomy patient charts were reviewed pre- and postoperatively for clinical and laboratory data related to infection. Patient level of infection was defined using the Weighted Level of Pulmonary Infection Tool, which was constructed for this study. Three categories of aseptic type emerged (clean, sterile, and mixed) because existing tracheotomy care procedures did not fall into one of the two hypothesized types. Data were analyzed using a maximum likelihood approach to mixed model analysis of variance or covariance. The findings indicated significant differences among the three procedures with laboratory, but not clinical, data. Laboratory data supported practicing clean procedures as those associated with the least postoperative infection.
正如文献报道及临床实践观察到的，目前使用了多种气管切开护理程序（气管切开吸痰和清洁技术）。本研究的目的是通过术后肺部感染水平来确定清洁气管切开护理是否比无菌护理更有效。选择了十家拥有大型头颈/耳鼻喉科服务的医院作为数据收集地点。在这些中心，至少对15例气管切开患者的术前和术后病历进行了审查，以获取与感染相关的临床和实验室数据。使用为本研究构建的肺部感染加权水平工具来定义患者的感染水平。由于现有的气管切开护理程序不属于两种假设类型中的任何一种，因此出现了三类无菌类型（清洁、无菌和混合）。使用最大似然法对混合模型方差分析或协方差分析进行数据分析。结果表明，三种程序在实验室数据方面存在显著差异，但在临床数据方面没有。实验室数据支持采用清洁程序，因为这些程序与术后感染最少相关。
