细节管理联合目标性监测降低ICU患者VAP发生率的实践效果  

Detail management combined with objective monitoring to reduce the incidence of VAP in ICU patients

作　　者：柳学梅[1] 周玉华[2] 陈素芝[1] LIU Xuemei;ZHOU Yuhua;CHEN Suzhi(Department of Critical Care Medicine of the Central Hospital of Shantou City,Shantou 515031,China;Nursing Department of the Central Hospital of Shantou City,Shantou 515031,China)

机构地区：[1]汕头市中心医院重症医学科,广东汕头515031 [2]汕头市中心医院护理部,广东汕头515031

出　　处：《河南大学学报（医学版）》2020年第2期115-118,共4页Journal of Henan University:Medical Science

摘　　要：[目的]探索细节管理联合目标性监测对降低ICU患者VAP发生率的实践效果。[方法]回顾性分析汕头市中心医院2018年1月至12月ICU采取常规护理联合目标性监测的ICU机械通气患者303例(为实施前组),追溯每一例VAP发病的案例,找出存在问题并制订干预措施。予2019年1月至12月的ICU机械通气患者306例实行细节管理联合目标性监测干预(为实施后组)。对比2组一般资料、VAP发生率、床头抬高合格率、手卫生依从性、口腔清洁率、及护理风险事件发生率。[结果]2组在一般资料上的差异无统计学意义(P>0.05);实施后组的VAP发生率低于实施前组;实施后组的护理风险事件发生率低于实施前组。床头抬高合格率实施后组明显高于实施前组,差异有统计学意义(P<0.05);手卫生依从性实施后组明显高于实施前组,差异有统计学意义(P<0.05);口腔清洁率实施后组明显高于实施前组,且差异有统计学意义(P<0.05)。[结论]细节管理联合目标性监测可以有效降低ICU患者VAP发生率,大大减少风险事件的发生,对VAP的防控措施有效落实。[Objective]To explore the practical effect of detail management combined with objective monitoring on reducing the incidence of ventilater related pneumonia(VAP)in ICU patients.[Methods]Retrospective analysis of 303 cases of ICU mechnical ventilation patients with routine care combined with targeted monitoring in our hospital from January to December 2018(being the pre-implementation group),traced back each case of VAP onset,indentifeied problems and formulated interventions measures to implement detailed management combined with targeted monitoring intervention(for the post-implementation group)in 306 ICU mechanicaly ventilated patients from January to December 2019(compared to the post-implementation group),comparing the general information,incidence of VAP,qualified rate of bed head elevation,and hand hygiene compliance,oral cleaning rate,and incidence of nursing risk events.[Results]There was no significant difference in general data between the two groups(P>0.05).The incidence of VAP in the post-implementation group was lower than that in the pre-implementation group.The incidence of nursing risk events in the post-implementation group was lower than that in the pre-implementation group,the qualified rate of the head of bed in the post-implementing group was significantly higher than that in the pre-implementation group,difference was statistically significant(P<0.05),hand hygiene compliance in post-implementation group were significantly higher than that in the pre-implementation group,the difference was statistically significant(P<0.05),the oral cleaning percentage of post-implementing group is obviously higher than that in pre-implementation,and the difference was statistically significant(P<0.05).[Conclusion]Detail management combined with objective monitoring can effectively reduce the incidence of VAP in ICU patients,greatly reduce the occurrence of risk events,and effectively implement the prevention and control measures of VAP.

关 键 词：细节管理 目标性监测 ICU VAP 

分 类 号：R473.56[医药卫生—护理学]