品管圈气道管理在老年重症肺炎患者多重耐药菌感染预防控制中的效果研究  

Effects of QCC Airway Management on Prevention and Control of Multi-Drug-Resistant Bacterial Infection in Elderly Patients with Severe Pneumoni

作　　者：李英珍[1] 梁华珍[2] 冉蒋鸿[3] Li Yingzhen;Liang Huazhen;Ran Jianghong(Department of Nosocomial Infection Management,Second People's Hospital of Qinzhou City,Guangxi,535000,P.R.China;Nursing Department,Second People's Hospital of Qinzhou City,Guangxi,535000,P.R.China;Department of Critical Care,Second People's Hospital of Qinzhou City,Guangxi,535000,P.R.China)

机构地区：[1]广西钦州市第二人民医院医院感染管理科,广西钦州535000 [2]广西钦州市第二人民医院护理部,广西钦州535000 [3]广西钦州市第二人民医院重症医学科二区,广西钦州535000

出　　处：《老年医学与保健》2020年第2期303-306,共4页Geriatrics & Health Care

摘　　要：目的观察品管圈气道管理在老年重症肺炎患者多重耐药菌感染预防控制中的效果,为治疗老年重症肺炎提供方法。方法选择2017年8月-2019年12月期间钦州市第二人民医院呼吸重症监护病房(RICU)收治的重症肺炎老年患者134例,随机分为2组:观察组(n=67)与对照组(n=67)。2组均接受相同的常规治疗,对照组采取ICU常规护理,观察组采取与对照组相同的ICU常规护理基础上加用品管圈气道管理护理。评估并比较2组护理人员预防控制多重耐药菌(MDRO)感染知识掌握程度、患者机械通气时间、呼吸机相关肺炎(VAP)发病率和MDRO检出率。结果观察组护理人员MDRO感染知识考核评分、ICU手卫生操作评分、气道及呼吸机护理管理评分和微生物样本留取评分均明显高于对照组护理人员(P<0.05);观察组ICU抢救机械通气时间明显少于对照组(P<0.05),观察组MDRO感染检出率明显低于对照组(P<0.05);观察组VAP发病率明显低于对照组(2.5‰vs 8.3‰,P<0.05)。结论品管圈气道管理可显著降低重症肺炎老年患者气道分泌物中MDRO检出率,提升护理人员对MDRO感染知识掌握程度,缩减呼吸机辅助呼吸时间,降低呼吸机相关肺炎发病率,有一定的临床应用价值。Objective To explore the effects of quality control circle(QCC) airway management on the prevention and control of multi-drug-resistant bacterial infection in elderly patients with severe pneumonia. Methods 134 elderly patients with severe pneumonia admitted to the respiratory intensive care unit(RICU) of our hospital from August 2017 to December2019 were randomly divided into two groups: the observation group and the control group, 67 cases in each group. The control group received routine ICU nursing intervention, while the observation group took the same ICU routine nursing as the control group and added the QCC airway management nursing. The knowledge of prevention and control of multi-drug resistant bacteria(MDRO) infection of the nurses, the duration of mechanical ventilation, the incidence of ventilator-associated pneumonia(VAP) and the detection rate of MDRO were evaluated and compared between both groups. Results MDRO infection knowledge assessment score, ICU hand hygiene operation score, airway and ventilator nursing management score and microbial sample retention score of the nurses in the observation group were significantly higher than those in the control group(P<0.05). The duration of ICU rescue mechanical ventilation of the observation group was significantly less than that of the control group(P<0.05), the detection rate of MDRO infection and the incidence of VAP were significantly lower than those of the control group(P<0.05). Conclusion QCC airway management can significantly reduce the detection rate of MDRO in the airway secretion of elderly patients with severe pneumonia, improve the nurses’ knowledge of MDRO infection, reduce the time of ventilator assisted breathing and the incidence of ventilator related pneumonia in elderly patients, which has certain clinical application value.

关 键 词：老年 重症肺炎 多重耐药菌感染 呼吸机相关肺炎 品管圈 气道管理 护理 

分 类 号：R473.5[医药卫生—护理学]