ICU护理风险管理对急性呼吸窘迫综合征患者呼吸机相关性肺炎的影响研究  

Effect of ICU nursing risk management on ARDS patients with ventilator associated pneumonia

作　　者：余燕梅[1] 刘利华[1] 蒋玉芳[1] 胡小梅[2] 袁颖 

机构地区：[1]海口市人民医院重症医学科,海南海口570208 [2]暨南大学附属华侨医院神经外科,广东广州510000 [3]咸宁市中心医院,湖北咸宁437000

出　　处：《中华医院感染学杂志》2016年第3期695-697,共3页Chinese Journal of Nosocomiology

基　　金：海口市重点科技计划基金资助项目(2011-0140)

摘　　要：目的探讨重症监护病房(ICU)护理风险管理对急性呼吸窘迫综合征(ARDS)患者呼吸机相关性肺炎(VAP)的影响,以降低VAP发生率。方法选取医院2014年1月-2015年8月ICU收治的ARDS机械通气患者196例,采用随机数字表法将患者分为两组,对照组96例采用ICU常规护理,观察组100例在对照组基础上采用ICU护理风险管理,比较两组VAP、护理风险事件、护理投诉与护理舒适度的差异。结果观察组患者VAP、护理风险事件发生率与护理投诉率均明显低于对照组;观察组护理满意率明显高于对照组;观察组护理舒适度的4个维度(心理、社会、环境、生理)评分均明显高于对照组;以上差异均有统计学意义(P<0.05)。结论 ICU护理风险管理有助于降低ARDS机械通气患者并发VAP风险,显著降低护理风险事件率与护理投诉率,提高护理舒适度,值得临床推广应用。OBJECTIVE To investigate the effect of care unit intensive（ICU）nursing risk management on ventilator associated pneumonia（VAP）in patients with acute respiratory distress syndrome（ARDS）,so as to decrease VAP rate.METHODS Totally 196 ARDS patients with mechanical ventilation in ICU in our hospital from Jan.2014 to Aug.2015 were selected and divided into two groups by random digital table.The control group（n=96）was given ICU conventional nursing,and the observation group was given ICU nursing risk management on the basis of treatment in the control group.VAP,nursing risk events,nursing complaints and nursing comfort were compared between the two groups.RESULTS The incidences of VAP,nursing risk events and nursing complaints in the observation group were significantly lower than in the control group.The nursing satisfaction rate in the observation group was significantly higher than that in the control group.Four-dimension scores of nursing comfort（psychological,social,environmental and physiological）in the observation group were significantly higher than in the control group（P〈0.05）.CONCLUSION Nursing risk management can significantly reduce the risk of VAP,significantly reduce the rate of nursing risk events and nursing complaints and improve comfort of ARDS patients with mechanical ventilation,which is worthy of clinical application.

关 键 词：重症监护病房 护理风险管理 急性呼吸窘迫综合征 呼吸机相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]