新生儿留置气管插管查检单的设计及应用  

Design and application of a checklist for neonatal indwelling tracheal intubation

作　　者：张瑞芳[1] 巩越丽[2] 李婷 杜杰[2] 吴超[2] 陈静[1] ZHANG Ruifang;GONG Yueli;LI Ting;DU Jie;WU Chao;CHEN Jing(Department of Pediatrics,Siping Central People's Hospital,Siping,Jilin province,136000,China)

机构地区：[1]四平市中心人民医院儿科,吉林省四平市136000 [2]四平市中心人民医院护理部,吉林省四平市136000 [3]四平市中心人民医院血液透析室,吉林省四平市136000

出　　处：《中国护理管理》2023年第3期356-362,共7页Chinese Nursing Management

基　　金：四平市卫生健康委员会护理质量改善项目(2021015)。

摘　　要：目的 :设计新生儿留置气管插管查检单,探讨其应用效果。方法 :成立研究小组,通过文献回顾、小组讨论等方法设计查检单,采用面对面或网络发送问卷的形式进行两轮专家咨询,根据专家意见进行讨论修改后形成新生儿留置气管插管查检单终稿。将吉林省某三级甲等医院新生儿监护室2020年1月—12月符合标准的34例气管插管患儿作为对照组,2021年1月—10月的34例患儿作为实验组。对照组采用常规气管插管护理,实验组在常规气管插管护理措施基础上采用查检单干预,比较两组患儿气管插管相关并发症发生率及护士在应用查检单前后对查检单的认知和行为得分。结果 :实验组患儿呼吸机相关肺炎、气管导管移位、医源性皮肤损伤发生率均低于对照组(P<0.05);应用查检单后护士对气管插管风险认知和行为得分高于应用前(P<0.05)。结论 :新生儿留置气管插管查检单的应用,可有效降低并发症发生率,提高护士风险认知及行为能力。Objective:To design a checklist for indwelling tracheal intubation in neonates and evaluate its application outcomes.Methods:A research group was set up to design the checklist through literature review and group discussion.Two rounds of expert consultation were conducted in the form of face-to-face or online questionnaires.The final draft of the checklist for neonatal endotracheal intubation was developed after discussion and modification according to expert opinions.We recruited 34 children with endotracheal intubation in the neonatal care unit of a tertiary A hospital in Jilin Province from January to December 2020 to the control group,and 34 children from January to October 2021 to the experimental group.The control group used routine tracheal intubation nursing as the intervention,and the experimental group used the checklist and routine tracheal intubation nursing as interventions.The incidence of trachea intubation related complications in the two groups and nurses'cognitive and behavioral scores on the checklist were evaluated.Results:The incidence of Ventilator-Associated Pneumonia,tracheal tube displacement and iatrogenic skin injury in the experimental group were lower than those in the control group(P<0.05).Nurses had higher scores on risk perception and behavior of endotracheal intubation after using the checklist(P<0.05).Conclusion:The application of neonatal endotracheal intubation checklist can effectively reduce the incidence of complications and improve nurses'risk awareness and behavior.

关 键 词：查检单 呼吸机相关性肺炎 气管导管移位 医源性皮肤损伤 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]