集束化护理对降低ICU气管内插管非计划拔管率的效果  

Effect of Cluster Nursing on Reducing Unplanned Extubation Rate in ICU Patients with Endotracheal Intubation

作　　者：柳学梅[1] 

机构地区：[1]汕头市中心医院ICU,广东汕头515000

出　　处：《现代临床医学》2016年第4期299-301,共3页Journal of Modern Clinical Medicine

摘　　要：目的:探讨集束化护理对降低ICU气管内插管患者非计划拔管率的效果。方法:选取我院ICU收治的250例行机械通气治疗患者,将其随机分为观察组和对照组,每组125例。观察组给予集束化护理措施,对照组给予常规护理,比较2组患者的机械通气时间、ICU住院时间,观察2组ICU住院期间不良事件情况,分析呼吸机相关性肺炎、非计划拔管的发生率及非计划拔管原因。结果:观察组患者的机械通气时间、ICU住院时间均较对照组明显缩短,ICU不良事件各项目评分均低于对照组,非计划拔管的发生率明显少于对照组。镇静不充分、约束不到位以及操作不当是导致非计划性拔管的主要原因。结论:集束化护理措施应用于ICU机械通气患者的处理能够显著降低各种原因引起的非计划性拔管及ICU住院期间不良事件发生,缩短机械通气时间以及住院时间,值得推广应用。Objective： To study the effect of cluster nursing on reducing the unplanned extubation rate in ICU patients with endotracheal intubation. Methods： 250 patients receiving mechanical ventilation in ICU of our hospital were randomly divided into observation group（ 125 cases） and control group（ 125 cases）. The observation group was given cluster nursing measures while the control group was given routine nursing care. Mechanical ventilation time and length of ICU stay,incidence of ventilator associated pneumonia,and rate of unplanned extubation were compared between the two groups. Adverse events during ICU stay were observed and the causes of unplanned extubaion were analyzed in the two groups. Results： Mechanical ventilation time and length of ICU stay in the observation group were significantly shorter than those in the control group; the rate of unplanned extubation and the incidence of ventilator associated pneumonia were lower than those in the control group; each score of adverse events in the observation group was lower than that in the control group; the ratios of unplanned extubation due to inadequate sedation,restriction not well-done and misoperation were significantly different from those in the control group（ all P 0. 05）.Conclusion： Cluster nursing applied in ICU patients receiving mechanical ventilation can significantly reduce unplanned extubation caused by various reasons and adverse events during ICU stay,and shorten the time of mechanical ventilation and length of stay. Thus,it is worthy of popularization and application.

关 键 词：集束化护理 机械通气 ICU 非计划拔管 

分 类 号：R473.6[医药卫生—护理学]