基于失效模式和效果分析模式的督导式预警性护理预防成人心脏术后通气患者呼吸机相关性肺炎发生的效果  

Effect of supervised early warning nursing based on failure mode and effect analysis mode on prevention of ventilator associated pneumonia in adult patients with postoperative ventilation after cardiac surgery

作　　者：邢丽娜 李芳[1] 彭晓红[1] XING Lina;LI Fang;PENG Xiaohong(The Second Department of Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,新疆乌鲁木齐830000

出　　处：《中国医药导报》2024年第6期181-184,共4页China Medical Herald

摘　　要：目的 探讨基于失效模式和效果分析(FMEA)模式的督导式预警性护理对成人心脏术后通气患者呼吸机相关性肺炎(VAP)发生的预防效果。方法 选取2020年11月至2022年11月新疆医科大学第一附属医院重症医学二科心脏术后接受通气治疗的84例成人患者为研究对象,根据随机数字表法将患者分为对照组与观察组,各47例。对照组采用常规护理方法,观察组在此基础上采用基于FMEA模式的督导式预警性护理干预,两组均护理15 d。比较两组护理期间VAP发生情况、机械通气治疗时间、住院时间及护理前后血气分析指标变化情况。结果 观察组VAP发生率低于对照组(P<0.05);观察组住院时间、机械通气治疗时间短于对照组(P<0.05);护理后,两组动脉血氧分压水平高于治疗前,且观察组高于对照组(P<0.05);护理后,两组动脉血二氧化碳分压水平均低于治疗前,且观察组低于对照组(P<0.05)。结论 应用基于FMEA模式的督导式预警性护理可有效预防成人心脏术后通气患者VAP的发生,缩短机械通气治疗时间及住院时间,改善动脉血气。Objective To explore preventive effect of supervised early warning nursing based on failure mode and effect analysis(FMEA) mode on the occurrence of ventilator associated pneumonia(VAP) in adult patients with postoperative ventilation after cardiac surgery.Methods A total of 84 adult patients receiving ventilation therapy after cardiac surgery in the Second Department of Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from November2020 to November 2022 were selected as the study objects.According to random number table method,the patients were divided into control group and observation group,with 47 cases in each group.The control group was treated with routine nursing method,and the observation group was treated with supervised early warning nursing intervention based on FMEA mode.Both groups were treated for 15 days.The occurrence of VAP,the time of mechanical ventilation treatment,the time of hospitalization,and the changes of blood gas analysis indexes before and after nursing were compared between the two groups.Results The incidence of VAP in observation group was lower than that in control group(P<0.05).The duration of hospitalization and mechanical ventilation in observation group were shorter than those in control group(P<0.05).After nursing,the level of arterial blood oxygen partial pressure in both groups was higher than that before treatment,and the observation group was higher than the control group(P<0.05).After nursing,the level of arterial blood carbon dioxide partial pressure in both groups was lower than that before treatment,and the observation group was lower than the control group(P<0.05).Conclusion Application of supervised early warning nursing based on FMEA mode can effectively prevent occurrence of VAP in adult patients with postoperative ventilation after cardiac surgery,shorten treatment time of mechanical ventilation and hospitalization time,and improve arterial blood gas.

关 键 词：心脏手术 督导式预警性护理 失效模式和效果分析模式 呼吸机相关性肺炎 

分 类 号：R473[医药卫生—护理学]